Individual provider Active NPI

Marissa Collins, DPT

  • Physical Therapist
  • N Charleston, SC
National Provider Identifier
1790233484
Registry record updated Jun 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
8280 Issued in SC
Practice address
9241 University Blvd
Ste B-1
N Charleston, SC 29406-9349
Phone
(843) 764-4887
Fax
(843) 864-4509
NPI assigned
Sep 12, 2016
Last updated
Jun 15, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 15, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 8280 SC Primary

Addresses

Primary practice location

9241 University Blvd
Ste B-1
N Charleston, SC 29406-9349

Mailing address

790 Remington Blvd
Bolingbrook, IL 60440-4909
Phone (630) 296-2223

Other names 1

  • Marissa Nocera Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230301001421 FL Practitioner - Physical Therapist in Private Practice 7416234976

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
8280SCMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Rehabworks LLC Physical Therapist CurrentSince Oct 13, 2022 Accepting new patients

Locations

7273 Vanderbilt Beach Rd
Ste 18
Naples, FL 34119
Phone (239) 734-3404

Networks

  • Freedom Health HMO Network

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1473638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686787200000",
    "number": "1790233484",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "790 REMINGTON BLVD",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604404909",
            "telephone_number": "630-296-2223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9241 UNIVERSITY BLVD",
            "address_2": "STE B-1",
            "city": "N CHARLESTON",
            "state": "SC",
            "postal_code": "294069349",
            "telephone_number": "843-764-4887",
            "fax_number": "843-864-4509"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLLINS",
        "first_name": "MARISSA",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-09-12",
        "last_updated": "2023-06-15",
        "certification_date": "2023-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "SC",
            "license": "8280",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARISSA",
            "last_name": "NOCERA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in N Charleston, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2023; 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.