Individual provider Active NPI

Marjorie Ackerman

  • Physical Therapist
  • Skagway, AK
National Provider Identifier
1770974008
Registry record updated Feb 9, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
578 Issued in AK
Practice address
350 14TH Ave
Skagway, AK 99840-0302
Phone
(907) 983-2255
NPI assigned
Feb 9, 2015
Sex
Female
Sole proprietor
Yes

Organizations & group practices 1

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.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in AK

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20150328000330 AK Practitioner - Physical Therapist in Private Practice 1557688694 Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
578AKMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Municipality of Skagway Current
since Feb 23, 2015
Accepting new patients

Interoperability endpoints

  • Direct secure messaging: margie.ackerman.1@15635.direct.athenahealth.com

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 578 AK Primary

Addresses

NPPES NPI Registry

Primary practice location

350 14TH Ave
Skagway, AK 99840-0302

Mailing address

781 Main St.
Skagway, AK 99840-0302
Phone (559) 679-7746

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Feb 9, 2015.

{
    "created_epoch": "1423440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1423440000000",
    "number": "1770974008",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "781 MAIN ST.",
            "city": "SKAGWAY",
            "state": "AK",
            "postal_code": "998400302",
            "telephone_number": "559-679-7746"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 14TH AVE",
            "city": "SKAGWAY",
            "state": "AK",
            "postal_code": "998400302",
            "telephone_number": "907-983-2255"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ACKERMAN",
        "first_name": "MARJORIE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-02-09",
        "last_updated": "2015-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AK",
            "license": "578",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Skagway, AK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.