Active NPI
Tara Krista Marchand, OT
- Clinic/Center
- Saint Johns, FL
National Provider Identifier
1770813735
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinic/Center
- License
- OT6407
- Practice address
- 1108 Basil Branch CT
Saint Johns, FL 32259-5260 - Phone
- (904) 434-5107
- Fax
- (904) 230-6823
- NPI assigned
- Jan 13, 2010
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Clinic/Center | 261Q00000X | OT6407 | FL | Primary |
Addresses
Primary practice location
1108 Basil Branch CT
Saint Johns, FL 32259-5260
Mailing address
1108 Basil Branch CT
Saint Johns, FL 32259-5260
Phone (904) 434-5107
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 |
|---|---|---|---|
| OT6407 | FL | MD | Clinic/Center |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1263340800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1263340800000",
"number": "1770813735",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1108 BASIL BRANCH CT",
"city": "SAINT JOHNS",
"state": "FL",
"postal_code": "322595260",
"telephone_number": "904-434-5107",
"fax_number": "904-230-6823"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1108 BASIL BRANCH CT",
"city": "SAINT JOHNS",
"state": "FL",
"postal_code": "322595260",
"telephone_number": "904-434-5107",
"fax_number": "904-230-6823"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARCHAND",
"first_name": "TARA",
"middle_name": "KRISTA",
"credential": "OT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-01-13",
"last_updated": "2010-01-13",
"status": "A"
},
"taxonomies": [
{
"code": "261Q00000X",
"taxonomy_group": "",
"desc": "Clinic/Center",
"state": "FL",
"license": "OT6407",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Saint Johns, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.