Individual provider Active NPI

Mark Franklin Staples, PT

  • Physical Therapist
  • Alexander City, AL
National Provider Identifier
1669479754
Registry record updated Apr 22, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PTH 1013 Issued in AL
Practice address
1120 Airport Dr
Ste 103
Alexander City, AL 35010-3444
Phone
(256) 329-8180
Fax
(256) 329-8116
NPI assigned
Jul 5, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2008

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 PTH 1013 AL Primary

Addresses

Primary practice location

1120 Airport Dr
Ste 103
Alexander City, AL 35010-3444

Mailing address

1594 Beri Barfield Dr
Dadeville, AL 36853-4808
Phone (256) 285-7456

Other identifiers 1

IdentifierTypeStateIssuer
510-77002OtherALBCBS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050104000913 AL Practitioner - Physical Therapist in Private Practice 8325096514 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Elite Rehab Solutions Partners, LLCGroup PAC ID 7719317585, 4 clinicians

Practice addresses (Care Compare)

1120 Airport Dr
Suite 103
Alexander City, AL 35010-3444
Phone (256) 392-4896

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PTH 1013ALMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Elite Rehab Solutions Partners LLC Physical Therapist CurrentSince Oct 2, 2024 Accepting new patients
Dadeville Sports Medicine & Physical Therapy Physical Therapist CurrentSince Jun 19, 1997 Accepting new patients

Locations

1120 Airport Dr
Ste 103
Alexander City, AL 35010
Phone (256) 329-8180

309 Mariarden Rd
Dadeville, AL 36853
Phone (256) 825-2303

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1120521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1208822400000",
    "number": "1669479754",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1594 BERI BARFIELD DR",
            "city": "DADEVILLE",
            "state": "AL",
            "postal_code": "368534808",
            "telephone_number": "256-285-7456"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1120 AIRPORT DR",
            "address_2": "STE 103",
            "city": "ALEXANDER CITY",
            "state": "AL",
            "postal_code": "350103444",
            "telephone_number": "256-329-8180",
            "fax_number": "256-329-8116"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STAPLES",
        "first_name": "MARK",
        "middle_name": "FRANKLIN",
        "name_prefix": "Mr.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-05",
        "last_updated": "2008-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AL",
            "license": "PTH 1013",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "510-77002",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Alexander City, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.