Individual provider Active NPI

Marsha Ann Ingersoll

  • Physical Therapist
  • Saint Joseph, MO
National Provider Identifier
1609988955
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
00710 Issued in MO
Practice address
3303 Frederick Ave
Saint Joseph, MO 64506-2985
Phone
(816) 364-3836
Fax
(816) 390-8546
NPI assigned
Aug 31, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 00710 MO Primary

Addresses

Primary practice location

3303 Frederick Ave
Saint Joseph, MO 64506-2985

Mailing address

3303 Frederick Ave
Saint Joseph, MO 64506-2985
Phone (816) 364-3836

Other identifiers 1

IdentifierTypeStateIssuer
18596015OtherMOBC/BS

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
00710MOMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
United Cerebral Palsy of Northwest Missouri Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1609988955",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3303 FREDERICK AVE",
            "city": "SAINT JOSEPH",
            "state": "MO",
            "postal_code": "645062985",
            "telephone_number": "816-364-3836",
            "fax_number": "816-390-8546"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3303 FREDERICK AVE",
            "city": "SAINT JOSEPH",
            "state": "MO",
            "postal_code": "645062985",
            "telephone_number": "816-364-3836",
            "fax_number": "816-390-8546"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "INGERSOLL",
        "first_name": "MARSHA",
        "middle_name": "ANN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-31",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MO",
            "license": "00710",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS",
            "identifier": "18596015",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Joseph, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.