Individual provider Active NPI

Kevin George Mark, PT

  • Physical Therapist
  • Dansville, NY
National Provider Identifier
1508001900
Registry record updated Dec 13, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
007508-1 Issued in NY
Practice address
5936 Harter Rd
Dansville, NY 14437-9623
Phone
(585) 335-8284
NPI assigned
Dec 13, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 13, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 007508-1 NY Primary

Addresses

Primary practice location

5936 Harter Rd
Dansville, NY 14437-9623

Mailing address

5936 Harter Rd
Dansville, NY 14437-9623
Phone (585) 335-8284

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
007508-1NYMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1229126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1229126400000",
    "number": "1508001900",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5936 HARTER RD",
            "city": "DANSVILLE",
            "state": "NY",
            "postal_code": "144379623",
            "telephone_number": "585-335-8284"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5936 HARTER RD",
            "city": "DANSVILLE",
            "state": "NY",
            "postal_code": "144379623",
            "telephone_number": "585-335-8284"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARK",
        "first_name": "KEVIN",
        "middle_name": "GEORGE",
        "name_prefix": "Mr.",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-12-13",
        "last_updated": "2008-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "007508-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dansville, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2008; 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.