Active NPI
Marian Petty, HOLISTIC
- Religious Nonmedical Practitioner
- Sylacauga, AL
National Provider Identifier
1679218606
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Religious Nonmedical Practitioner
- Practice address
- 1023 W Fort Williams St
Sylacauga, AL 35150-2301 - Phone
- (256) 487-6072
- Fax
- (309) 863-5828
- NPI assigned
- May 4, 2022
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 6
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community Based Hospice Care Agency | 251G00000X | AL | ||
| Health Service Clinic/Center | 261QH0100X | AL | ||
| Religious Nonmedical Practitioner | 374K00000X | AL | Primary | |
| Specialist | 174400000X | |||
| Specialist | 174400000X | AL | ||
| Hand Physical Therapist | 2251H1200X | AL |
Addresses
Primary practice location
1023 W Fort Williams St
Sylacauga, AL 35150-2301
Mailing address
1023 W Fort Williams St
Sylacauga, AL 35150-2301
Phone (256) 487-6072
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1651622400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1653523200000",
"number": "1679218606",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1023 W FORT WILLIAMS ST",
"city": "SYLACAUGA",
"state": "AL",
"postal_code": "351502301",
"telephone_number": "256-487-6072",
"fax_number": "309-863-5828"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1023 W FORT WILLIAMS ST",
"city": "SYLACAUGA",
"state": "AL",
"postal_code": "351502301",
"telephone_number": "256-487-6072",
"fax_number": "309-863-5828"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PETTY",
"first_name": "MARIAN",
"credential": "HOLISTIC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-05-04",
"last_updated": "2022-05-26",
"certification_date": "2022-05-23",
"status": "A"
},
"taxonomies": [
{
"code": "251G00000X",
"taxonomy_group": "",
"desc": "Hospice Care, Community Based",
"state": "AL",
"license": null,
"primary": false
},
{
"code": "261QH0100X",
"taxonomy_group": "",
"desc": "Clinic/Center, Health Service",
"state": "AL",
"license": null,
"primary": false
},
{
"code": "374K00000X",
"taxonomy_group": "",
"desc": "Religious Nonmedical Practitioner",
"state": "AL",
"license": null,
"primary": true
},
{
"code": "174400000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Specialist",
"state": null,
"license": null,
"primary": false
},
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "AL",
"license": null,
"primary": false
},
{
"code": "2251H1200X",
"taxonomy_group": "",
"desc": "Physical Therapist, Hand",
"state": "AL",
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sylacauga, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.