Mariah Linn Bartrum, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

5502004913 Issued in MI

Practice address

23770 Hospital St
Cassopolis, MI 49031-9699

Phone

(269) 445-3801

NPI assigned

May 21, 2019

Last updated

May 21, 2019By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Mariah Gunn Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1558396800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1558396800000",
    "number": "1679130165",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "61606 SHERMAN LN",
            "city": "CASSOPOLIS",
            "state": "MI",
            "postal_code": "490318717",
            "telephone_number": "574-612-3816"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23770 HOSPITAL ST",
            "city": "CASSOPOLIS",
            "state": "MI",
            "postal_code": "490319699",
            "telephone_number": "269-445-3801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BARTRUM",
        "first_name": "MARIAH",
        "middle_name": "LINN",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-05-21",
        "last_updated": "2019-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "MI",
            "license": "5502004913",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARIAH",
            "last_name": "GUNN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Physical Therapy Assistant in Cassopolis, MI
• Providers in Cassopolis, MI by specialty
• Physical Therapy Assistant in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2019; 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.