Active NPI
Eric James Marnell II, PTA
- Physical Therapy Assistant
- Peabody, MA
National Provider Identifier
1790819902
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- AH 2389-PA
- Practice address
- 96 Forest St
Peabody, MA 01960-3907 - Phone
- (978) 532-0303
- NPI assigned
- Mar 16, 2007
- Sex
- Male
- 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 Therapy Assistant | 225200000X | AH 2389-PA | MA | Primary |
Addresses
Primary practice location
96 Forest St
Peabody, MA 01960-3907
Mailing address
112 Ledgewood Dr
Apt 11
Portsmouth, NH 03801-6409
Phone (603) 205-3673
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 |
|---|---|---|---|
| AH 2389-PA | MA | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1174003200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1790819902",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "112 LEDGEWOOD DR",
"address_2": "APT 11",
"city": "PORTSMOUTH",
"state": "NH",
"postal_code": "038016409",
"telephone_number": "603-205-3673"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "96 FOREST ST",
"city": "PEABODY",
"state": "MA",
"postal_code": "019603907",
"telephone_number": "978-532-0303"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARNELL",
"first_name": "ERIC",
"middle_name": "JAMES",
"name_prefix": "Mr.",
"name_suffix": "II",
"credential": "PTA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-03-16",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "MA",
"license": "AH 2389-PA",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Peabody, MA
- Jose Marchena, DMD,MD
- Jacquelyn Kathleen Marchetti
- Margaret a. Robinson
- Margaret a. Robinson, DO
- Samantha Marino, M.S. CCC-SLP
- Anna Martel, M.S.
- Mass General Brigham Medical Group Northern Massachusetts Inc
- Massachusetts Dental Arts, P.C.
- Massachusetts Dental Professionals, P.C.
- Massbay Adult Foster Care, LLC
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.