Individual provider Active NPI

Joni Shirk Marino, PTA

  • Physical Therapy Assistant
  • Columbia, SC
National Provider Identifier
1558726885
Registry record updated Dec 31, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
1745 Issued in SC
Practice address
731 Polo Rd
Columbia, SC 29223-4462
Phone
(803) 788-8655
NPI assigned
Dec 31, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 31, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 1745 SC Primary

Addresses

Primary practice location

731 Polo Rd
Columbia, SC 29223-4462

Mailing address

731 Polo Rd
Columbia, SC 29223-4462
Phone (803) 788-8655

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
1745SCMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1451520000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1451520000000",
    "number": "1558726885",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "731 POLO RD",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292234462",
            "telephone_number": "803-788-8655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "731 POLO RD",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292234462",
            "telephone_number": "803-788-8655"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARINO",
        "first_name": "JONI",
        "middle_name": "SHIRK",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-12-31",
        "last_updated": "2015-12-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "SC",
            "license": "1745",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 31, 2015; 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.