Active NPI
Marissa De Los Santos
- Physical Therapist
- Biloxi, MS
National Provider Identifier
1508337940
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT6160
- Practice address
- 2541 Pass Rd Ste F
Biloxi, MS 39531-2112 - Phone
- (228) 388-1002
- NPI assigned
- Dec 11, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT6160 | MS | Primary |
Addresses
Primary practice location
2541 Pass Rd Ste F
Biloxi, MS 39531-2112
Mailing address
251 Johnston St SE Ste 200
Decatur, AL 35601-2515
Phone (256) 350-1764
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
| License | State | Type | Specialty |
|---|---|---|---|
| PT6160 | MS | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1544486400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1544572800000",
"number": "1508337940",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "251 JOHNSTON ST SE STE 200",
"city": "DECATUR",
"state": "AL",
"postal_code": "356012515",
"telephone_number": "256-350-1764"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2541 PASS RD STE F",
"city": "BILOXI",
"state": "MS",
"postal_code": "395312112",
"telephone_number": "228-388-1002"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DE LOS SANTOS",
"first_name": "MARISSA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-12-11",
"last_updated": "2018-12-12",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MS",
"license": "PT6160",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Biloxi, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.