Marisa Kephart, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT011667L Issued in PA

Practice address

75 E Derry Rd
Hershey, PA 17033-2705

Phone

(717) 298-6245

Fax

(717) 298-7774

NPI assigned

Jun 12, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Family Practice Center, PC

  • Clinical Medical Laboratory
  • Selinsgrove, PA
  • NPI 1033322466
  NPD
• Family Practice Center, PC

  • Physical Therapist
  • Middleburg, PA
  • NPI 1154376937
  NPD

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

{
    "created_epoch": "1150070400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683504000000",
    "number": "1710929021",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "270 SUSQUEHANNA VALLEY MALL DR STE 300",
            "city": "SELINSGROVE",
            "state": "PA",
            "postal_code": "178709115",
            "telephone_number": "570-743-1703",
            "fax_number": "570-743-1728"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75 E DERRY RD",
            "city": "HERSHEY",
            "state": "PA",
            "postal_code": "170332705",
            "telephone_number": "717-298-6245",
            "fax_number": "717-298-7774"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEPHART",
        "first_name": "MARISA",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-06-12",
        "last_updated": "2023-05-08",
        "certification_date": "2023-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "PA",
            "license": "PT011667L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0018567660009",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• John Kemp, D.O.
• Jonathan Ken, MD
• Ella Marie Kennedy, CRNA
• Rae L Kennedy, MD
• Vincent R Kennedy, DO
• Amanda Louise Kercher
• Katherine Joanne Kereshi, M.D.
• Christopher D Kern, PA-C
• Stepfanie Jo Kern, PA-C
• Elizabeth Wijn Jones Kerris, MD

• Physical Therapist in Hershey, PA
• Providers in Hershey, PA by specialty
• Physical Therapist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2023; 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.