Marilyn J Nishi-Gormely, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT97780 Issued in CA

Practice address

14520 Mono Way
Ste 130
Sonora, CA 95370-9500

Phone

(209) 533-1273

Fax

(209) 533-1382

NPI assigned

Sep 14, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Mountain Physical Therapy, Inc., Dba

  • Physical Therapy Clinic/Center
  • Sonora, CA
  • NPI 1881793487

  Physical Therapist

  NPD (past)
• Hawaiian Rehabilitation Services Inc

  • Rehabilitation Clinic/Center
  • Kailua-Kona, HI
  • NPI 1518935162

  Physical Therapist

  NPD (past)

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

{
    "created_epoch": "1158192000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1324339200000",
    "number": "1538264486",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14520 MONO WAY",
            "address_2": "SUITE 130",
            "city": "SONORA",
            "state": "CA",
            "postal_code": "953709500",
            "telephone_number": "209-533-1273",
            "fax_number": "209-533-1382"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14520 MONO WAY",
            "address_2": "STE 130",
            "city": "SONORA",
            "state": "CA",
            "postal_code": "953709500",
            "telephone_number": "209-533-1273",
            "fax_number": "209-533-1382"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NISHI-GORMELY",
        "first_name": "MARILYN",
        "middle_name": "J",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-14",
        "last_updated": "2011-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT97780",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00064243",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "ZZZ39907Z",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Zachary Lee Nichols, DO
• Carol E Nicholson, CADC-CAS
• Karen Marie Nickols, C.M.T.
• Denise Anne Nicolini, RN, FNP
• Nightingale Center for Advanced Practice Nursing
• Patricia Louise Noonan, LMSW
• Airell Leighton Nygaard, M.D.
• Taylor R O'Connor
• Ian Robert O'Sullivan, MD, PHD
• Jester Mark Callejo Odrunia

• Physical Therapist in Sonora, CA
• Providers in Sonora, CA by specialty
• Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 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.