Active NPI
Maranda Jane St. John
- Developmental Therapist
- Somerset, KY
National Provider Identifier
1700158565
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Developmental Therapist
- License
- 201132385
- Practice address
- 127 Old Monticello St
Somerset, KY 42501-2357 - Phone
- (606) 271-7878
- Fax
- (606) 678-2723
- NPI assigned
- Feb 8, 2012
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Developmental Therapist | 222Q00000X | 201132385 | KY | Primary |
Addresses
Primary practice location
127 Old Monticello St
Somerset, KY 42501-2357
Mailing address
127 Old Monticello St
Somerset, KY 42501-2357
Phone (606) 271-7878
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 201132385 | KY | MD | Developmental Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1328659200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1361750400000",
"number": "1700158565",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "127 OLD MONTICELLO ST",
"city": "SOMERSET",
"state": "KY",
"postal_code": "425012357",
"telephone_number": "606-271-7878",
"fax_number": "606-678-2723"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "127 OLD MONTICELLO ST",
"city": "SOMERSET",
"state": "KY",
"postal_code": "425012357",
"telephone_number": "606-271-7878",
"fax_number": "606-678-2723"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ST. JOHN",
"first_name": "MARANDA",
"middle_name": "JANE",
"name_prefix": "Mrs.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-02-08",
"last_updated": "2013-02-25",
"status": "A"
},
"taxonomies": [
{
"code": "222Q00000X",
"taxonomy_group": "",
"desc": "Developmental Therapist",
"state": "KY",
"license": "201132385",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Somerset, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.