Individual provider Active NPI

Marla B. Hampton, PT

  • Physical Therapist
  • Southlake, TX
National Provider Identifier
1669410429
Registry record updated Sep 19, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
1020626 Issued in TX
Practice address
680 N Carroll Ave
Suite 120
Southlake, TX 76092-6411
Phone
(817) 421-9111
NPI assigned
Jun 3, 2006
Last updated
Sep 19, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 19, 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 1020626 TX Primary

Addresses

Primary practice location

680 N Carroll Ave
Suite 120
Southlake, TX 76092-6411

Mailing address

PO Box 92248
Southlake, TX 76092-0103
Phone (817) 421-9111

Other identifiers 1

IdentifierTypeStateIssuer
8T6157OtherTXBCBS

Other names 1

  • Marla Diane Beasley Former name

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

Practice roles

OrganizationSpecialtyStatusNew patients
Gemini Concepts, Inc Past Accepting new patients
Gary a. Ogin, MD, PA Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1149292800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1190160000000",
    "number": "1669410429",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 92248",
            "city": "SOUTHLAKE",
            "state": "TX",
            "postal_code": "760920103",
            "telephone_number": "817-421-9111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "680 N CARROLL AVE",
            "address_2": "SUITE 120",
            "city": "SOUTHLAKE",
            "state": "TX",
            "postal_code": "760926411",
            "telephone_number": "817-421-9111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAMPTON",
        "first_name": "MARLA",
        "middle_name": "B.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-03",
        "last_updated": "2007-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "1020626",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "8T6157",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARLA",
            "last_name": "BEASLEY",
            "middle_name": "DIANE",
            "credential": "PT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Southlake, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 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.