Kim C Marley

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

PTA-240 Issued in ID

Practice address

476978 Hwy 95
Ponderay, ID 83852-6978

Phone

(208) 263-7577

NPI assigned

Apr 21, 2011

Last updated

Apr 21, 2011By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1303344000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1303344000000",
    "number": "1487945770",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 317",
            "city": "PONDERAY",
            "state": "ID",
            "postal_code": "838520317",
            "telephone_number": "208-263-7577"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "476978 HWY 95",
            "city": "PONDERAY",
            "state": "ID",
            "postal_code": "838526978",
            "telephone_number": "208-263-7577"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARLEY",
        "first_name": "KIM",
        "middle_name": "C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-04-21",
        "last_updated": "2011-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "ID",
            "license": "PTA-240",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ryan Leisy, D.C.
• Lincare Inc
• Alice Loraine, DPT, OMS
• Benjamin Lusk, DPT
• Adelaida Mahler, LMT
• Matthew Wittwer Chiropractic, P.L.L.C. (By Design Chiropractic)
• Amy McGrath, PHARMACIST
• Michael R Dibenedetto MD PLLC (Seasons Plastic & Reconstructive Surgery)
• Michael R Dibenedetto MD PLLC (North Idaho Cardiac Rehabilitation)
• Nicholas G Miller, D.M.D

• Physical Therapy Assistant in Ponderay, ID
• Providers in Ponderay, ID by specialty
• Physical Therapy Assistant in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.