Active NPI
Lori Ann Marmon, PT
- Physical Therapist
- North Canton, OH
National Provider Identifier
1730100967
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT 008098
- Practice address
- 6046 Whipple Ave NW
North Canton, OH 44720-7616 - Phone
- (330) 494-1912
- Fax
- (330) 494-1915
- NPI assigned
- Jul 22, 2006
- 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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT 008098 | OH | Primary |
Addresses
Primary practice location
6046 Whipple Ave NW
North Canton, OH 44720-7616
Mailing address
4645 Belpar St NW
Canton, OH 44718-3602
Phone (330) 493-4210
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000000134713 | Other | OH | ANTHEM BC/BS |
Other names 1
- Miss Lori Ann Wiles
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 |
|---|---|---|---|
| PT 008098 | OH | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153526400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1730100967",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4645 BELPAR ST NW",
"city": "CANTON",
"state": "OH",
"postal_code": "447183602",
"telephone_number": "330-493-4210",
"fax_number": "330-493-4744"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6046 WHIPPLE AVE NW",
"city": "NORTH CANTON",
"state": "OH",
"postal_code": "447207616",
"telephone_number": "330-494-1912",
"fax_number": "330-494-1915"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARMON",
"first_name": "LORI",
"middle_name": "ANN",
"name_prefix": "Mrs.",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-07-22",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "OH",
"license": "PT 008098",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM BC/BS",
"identifier": "000000134713",
"state": "OH"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "LORI",
"last_name": "WILES",
"middle_name": "ANN",
"prefix": "MISS",
"credential": "PT",
"code": "1",
"type": "Former Name"
}
]
}
Other providers in North Canton, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.