Individual provider Active NPI

Marnie Williamson

  • Physical Therapy Assistant
  • Colorado Springs, CO
National Provider Identifier
1619231610
Registry record updated Mar 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
12837 Issued in CO
Practice address
8775 Moss Rock Rd
Colorado Springs, CO 80908-1230
Phone
(719) 287-3090
NPI assigned
Jun 25, 2012
Last updated
Mar 21, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 21, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 12837 CO Primary
Massage Therapist 225700000X 0025604 CO

Addresses

Primary practice location

8775 Moss Rock Rd
Colorado Springs, CO 80908-1230

Mailing address

3627 Meadowland Blvd
Colorado Springs, CO 80918-4531

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
12837COMDPhysical Therapy Assistant
0025604COMDMassage Therapist

NPI Registry JSON

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

{
    "created_epoch": "1340582400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679356800000",
    "number": "1619231610",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3627 MEADOWLAND BLVD",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809184531"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8775 MOSS ROCK RD",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809081230",
            "telephone_number": "719-287-3090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMSON",
        "first_name": "MARNIE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-06-25",
        "last_updated": "2023-03-21",
        "certification_date": "2023-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "CO",
            "license": "12837",
            "primary": true
        },
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "CO",
            "license": "0025604",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Colorado Springs, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2023; 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.