Individual provider Active NPI

Peter Marinakis, PH.D, M.AC, L.AC.

  • Acupuncturist
  • Annapolis, MD
National Provider Identifier
1790080661
Registry record updated Jan 24, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
AcupuncturistTaxonomy code 171100000X
License
U-00190 Issued in MD
Practice address
645 Ridgely Ave
Annapolis, MD 21401-1069
Phone
(410) 266-9370
NPI assigned
Jan 24, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 24, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acupuncturist 171100000X U-00190 MD Primary

Addresses

Primary practice location

645 Ridgely Ave
Annapolis, MD 21401-1069

Mailing address

2966 Edgewater Dr
Edgewater, MD 21037-1306
Phone (410) 266-9370

Other identifiers 2

IdentifierTypeStateIssuer
341991177OtherMDTAX ID
U-00190OtherMDLICENSE NUMBER

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
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
U-00190MDMDAcupuncturist

NPI Registry JSON

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

{
    "created_epoch": "1295827200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1295827200000",
    "number": "1790080661",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2966 EDGEWATER DR",
            "city": "EDGEWATER",
            "state": "MD",
            "postal_code": "210371306",
            "telephone_number": "410-266-9370"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "645 RIDGELY AVE",
            "city": "ANNAPOLIS",
            "state": "MD",
            "postal_code": "214011069",
            "telephone_number": "410-266-9370"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARINAKIS",
        "first_name": "PETER",
        "credential": "PH.D, M.AC, L.AC.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-01-24",
        "last_updated": "2011-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "MD",
            "license": "U-00190",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID",
            "identifier": "341991177",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE NUMBER",
            "identifier": "U-00190",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Annapolis, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2011; 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.