Active NPI
Angela Nicole Marzolf, COTA/L
- Occupational Therapy Assistant
- Williston, SC
National Provider Identifier
1619211521
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapy Assistant
- License
- 2925
- Practice address
- 5721 Springfield Rd
Williston, SC 29853 - Phone
- (803) 266-3229
- NPI assigned
- Nov 15, 2012
- Last updated
- Nov 16, 2012
- 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 |
|---|---|---|---|---|
| Occupational Therapy Assistant | 224Z00000X | 2925 | SC | Primary |
Addresses
Primary practice location
5721 Springfield Rd
Williston, SC 29853
Mailing address
419 Blue Ridge Dr
Martinez, GA 30907-2765
Phone (706) 664-8294
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
| License | State | Type | Specialty |
|---|---|---|---|
| 2925 | SC | MD | Certified Registered Nurse Anesthetist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1352937600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1353024000000",
"number": "1619211521",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "419 BLUE RIDGE DR",
"city": "MARTINEZ",
"state": "GA",
"postal_code": "309072765",
"telephone_number": "706-664-8294"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5721 SPRINGFIELD RD",
"city": "WILLISTON",
"state": "SC",
"postal_code": "29853",
"telephone_number": "803-266-3229"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARZOLF",
"first_name": "ANGELA",
"middle_name": "NICOLE",
"name_prefix": "Ms.",
"credential": "COTA/L",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-11-15",
"last_updated": "2012-11-16",
"status": "A"
},
"taxonomies": [
{
"code": "224Z00000X",
"taxonomy_group": "",
"desc": "Occupational Therapy Assistant",
"state": "SC",
"license": "2925",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Williston, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.