Active NPI
Lisa Ann Marino, PT, DPT
- Physical Therapist
- Sidney, OH
National Provider Identifier
1558879353
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 016340
- Practice address
- 804 W Russell Rd
Sidney, OH 45365-9063 - Phone
- (937) 232-5237
- NPI assigned
- Jan 15, 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 | 016340 | OH | Primary |
Addresses
Primary practice location
804 W Russell Rd
Sidney, OH 45365-9063
Mailing address
12855 Sidney Freyburg Rd
Anna, OH 45302-8716
Phone (937) 232-5237
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 016340 | OH | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1515974400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1714003200000",
"number": "1558879353",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12855 SIDNEY FREYBURG RD",
"city": "ANNA",
"state": "OH",
"postal_code": "453028716",
"telephone_number": "937-232-5237"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "804 W RUSSELL RD",
"city": "SIDNEY",
"state": "OH",
"postal_code": "453659063",
"telephone_number": "937-232-5237"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARINO",
"first_name": "LISA",
"middle_name": "ANN",
"name_prefix": "Dr.",
"credential": "PT, DPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-01-15",
"last_updated": "2024-04-25",
"certification_date": "2024-04-25",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "OH",
"license": "016340",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sidney, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.