Individual provider Active NPI

Marsha Gill, OMT COM

  • Specialist
  • Peoria, AZ
National Provider Identifier
1538540414
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
554 Issued in AZ
Practice address
14050 N 83Rd Ave
Suite 290
Peoria, AZ 85381-5638
Phone
(602) 796-6070
Fax
(888) 796-9570
NPI assigned
Jun 16, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Therapist 125J00000X 554 AZ
Oral Medicine Dentistry 125Q00000X 554 AZ
Physical Therapist 225100000X
Specialist 174400000X 554 AZ Primary

Addresses

Primary practice location

14050 N 83Rd Ave
Suite 290
Peoria, AZ 85381-5638

Mailing address

8447 W Desert Elm LN
Peoria, AZ 85383-3645
Phone (602) 796-6070

Other practice location 1

9772 W Yearling Rd Ste A1600
Peoria, AZ 85383-1380
Phone (602) 796-6070

Other names 1

  • Ms. Marci Mary Gill Professional name

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
554AZMDAthletic Trainer

NPI Registry JSON

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

{
    "created_epoch": "1434412800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1538540414",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8447 W DESERT ELM LN",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853833645",
            "telephone_number": "602-796-6070",
            "fax_number": "888-796-9570"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14050 N 83RD AVE",
            "address_2": "SUITE 290",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853815638",
            "telephone_number": "602-796-6070",
            "fax_number": "888-796-9570"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9772 W Yearling Rd Ste A1600",
            "address_purpose": "LOCATION",
            "city": "Peoria",
            "state": "AZ",
            "postal_code": "853831380",
            "country_code": "US",
            "telephone_number": "602-796-6070",
            "fax_number": "602-796-6070",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GILL",
        "first_name": "MARSHA",
        "credential": "OMT COM",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-06-16",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "125J00000X",
            "taxonomy_group": "",
            "desc": "Dental Therapist",
            "state": "AZ",
            "license": "554",
            "primary": false
        },
        {
            "code": "125Q00000X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral Medicine",
            "state": "AZ",
            "license": "554",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "AZ",
            "license": "554",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARCI",
            "last_name": "GILL",
            "middle_name": "MARY",
            "prefix": "MS.",
            "credential": "OMT COM",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Peoria, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.