Active NPI
Matthew Marrie, DPT
- Physical Therapist
- Lewes, DE
National Provider Identifier
1689234353
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT027736
- Practice address
- 12100 Black Swan Dr Ste 202
Lewes, DE 19958-4991 - Phone
- (302) 449-6476
- NPI assigned
- Jun 16, 2019
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT027736 | PA | Primary |
Addresses
Primary practice location
12100 Black Swan Dr Ste 202
Lewes, DE 19958-4991
Mailing address
1050 Industrial Dr Ste 202
Middletown, DE 19709-2803
Other practice location 1
3301 Market St Rm 210
Philadelphia, PA 19104-5004
Phone (215) 571-4287
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT027736 | PA | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Drexel University | Past | Accepting new patients | |
| Drexel University | 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 and National Provider Directory roles.
-
- Internal Medicine Physician
- Philadelphia, PA
- NPI 1538279732
-
- Maternal & Fetal Medicine Physician
- Philadelphia, PA
- NPI 1629005152
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1560643200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1607299200000",
"number": "1689234353",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1050 INDUSTRIAL DR STE 202",
"city": "MIDDLETOWN",
"state": "DE",
"postal_code": "197092803"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12100 BLACK SWAN DR STE 202",
"city": "LEWES",
"state": "DE",
"postal_code": "199584991",
"telephone_number": "302-449-6476"
}
],
"practiceLocations": [
{
"address_1": "3301 Market St Rm 210",
"address_purpose": "LOCATION",
"city": "Philadelphia",
"state": "PA",
"postal_code": "191045004",
"country_code": "US",
"telephone_number": "215-571-4287",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MARRIE",
"first_name": "MATTHEW",
"credential": "DPT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2019-06-16",
"last_updated": "2020-12-07",
"certification_date": "2020-12-07",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "PA",
"license": "PT027736",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lewes, DE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.