Individual provider Active NPI

Marion Joyce Addis, P.T.

  • Pediatric Physical Therapist
  • Williamsburg, VA
National Provider Identifier
1508181538
Registry record updated Apr 1, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Physical TherapistTaxonomy code 2251P0200X
License
2305206408 Issued in VA
Practice address
113 Heathery
Williamsburg, VA 23188-9133
Phone
(757) 208-0419
NPI assigned
Apr 1, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 2305206408 VA
Pediatric Physical Therapist 2251P0200X 2305206408 VA Primary

Addresses

Primary practice location

113 Heathery
Williamsburg, VA 23188-9133

Mailing address

113 Heathery
Williamsburg, VA 23188-9133
Phone (757) 208-0419

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
2305206408VAMDPediatric Physical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1270080000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1270080000000",
    "number": "1508181538",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "113 HEATHERY",
            "city": "WILLIAMSBURG",
            "state": "VA",
            "postal_code": "231889133",
            "telephone_number": "757-208-0419"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "113 HEATHERY",
            "city": "WILLIAMSBURG",
            "state": "VA",
            "postal_code": "231889133",
            "telephone_number": "757-208-0419"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ADDIS",
        "first_name": "MARION",
        "middle_name": "JOYCE",
        "name_prefix": "Ms.",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-04-01",
        "last_updated": "2010-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "VA",
            "license": "2305206408",
            "primary": false
        },
        {
            "code": "2251P0200X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Pediatrics",
            "state": "VA",
            "license": "2305206408",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Williamsburg, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2010; 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.