Active NPI
Marlon Leo Kasekamp
- Private Vehicle
- Ellerslie, MD
National Provider Identifier
1710473285
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Private Vehicle
- License
- K-225-585-507-042
- Practice address
- 10113 Hopkins St
Ellerslie, MD 21529-1102 - Phone
- (301) 707-1930
- NPI assigned
- Jul 7, 2018
- Last updated
- Jul 7, 2018
- 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 |
|---|---|---|---|---|
| Private Vehicle | 347C00000X | K-225-585-507-042 | MD | Primary |
Addresses
Primary practice location
10113 Hopkins St
Ellerslie, MD 21529-1102
Mailing address
10113 Hopkins St
Ellerslie, MD 21529-1102
Phone (301) 707-1930
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 |
|---|---|---|---|
| K-225-585-507-042 | MD | MD | Private Vehicle |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1530921600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1530921600000",
"number": "1710473285",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10113 HOPKINS ST",
"city": "ELLERSLIE",
"state": "MD",
"postal_code": "215291102",
"telephone_number": "301-707-1930"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10113 HOPKINS ST",
"city": "ELLERSLIE",
"state": "MD",
"postal_code": "215291102",
"telephone_number": "301-707-1930"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KASEKAMP",
"first_name": "MARLON",
"middle_name": "LEO",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2018-07-07",
"last_updated": "2018-07-07",
"status": "A"
},
"taxonomies": [
{
"code": "347C00000X",
"taxonomy_group": "",
"desc": "Private Vehicle",
"state": "MD",
"license": "K-225-585-507-042",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ellerslie, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.