Individual provider Active NPI

Paul A. Marino, P.T.

  • Physical Therapist
  • Marietta, GA
National Provider Identifier
1699825422
Registry record updated Nov 7, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT003365 Issued in GA
Practice address
1809 Canton Rd
Suite 600
Marietta, GA 30066-6343
Phone
(678) 213-1560
Fax
(678) 213-1705
NPI assigned
Jan 12, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 7, 2008

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT003365 GA Primary
Orthopedic Physical Therapist 2251X0800X PT003365 GA

Addresses

Primary practice location

1809 Canton Rd
Suite 600
Marietta, GA 30066-6343

Mailing address

736 Johnson Ferry Rd
Suite a-12
Marietta, GA 30068-4379
Phone (770) 321-4720

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

LicenseStateTypeSpecialty
PT003365GAMDOrthopedic Physical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
High Performance Physical Therapy Centers Physical Therapist Past Accepting new patients
Body Pros Physical Therapy Physical Therapist 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.

NPI Registry JSON

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

{
    "created_epoch": "1168560000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1226016000000",
    "number": "1699825422",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "736 JOHNSON FERRY RD",
            "address_2": "SUITE A-12",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300684379",
            "telephone_number": "770-321-4720",
            "fax_number": "770-579-7060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1809 CANTON RD",
            "address_2": "SUITE 600",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300666343",
            "telephone_number": "678-213-1560",
            "fax_number": "678-213-1705"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARINO",
        "first_name": "PAUL",
        "middle_name": "A.",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-12",
        "last_updated": "2008-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "PT003365",
            "primary": true
        },
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "GA",
            "license": "PT003365",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marietta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2008; 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.