Individual provider Active NPI

Ruth-Alexandria Marks

  • Developmental Therapist
  • Fort Walton Beach, FL
National Provider Identifier
1871116392
Registry record updated Jun 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Developmental TherapistTaxonomy code 222Q00000X
Practice address
308 Miracle Strip Pkwy SW
Fort Walton Beach, FL 32548-5217
Phone
(850) 217-7643
NPI assigned
May 19, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 23, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Developmental Therapist 222Q00000X FL Primary

Addresses

Primary practice location

308 Miracle Strip Pkwy SW
Fort Walton Beach, FL 32548-5217

Mailing address

308 Miracle Strip Pkwy SW
Fort Walton Beach, FL 32548-5217
Phone (850) 217-7643

Other practice location 1

5747 E Bay Blvd
Gulf Breeze, FL 32563-9665
Phone (850) 307-8811

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

Practice roles

OrganizationSpecialtyStatusNew patients
Emerald Coast Behavior Inc PastSince May 1, 2020 Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1589846400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624406400000",
    "number": "1871116392",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "308 MIRACLE STRIP PKWY SW",
            "city": "FORT WALTON BEACH",
            "state": "FL",
            "postal_code": "325485217",
            "telephone_number": "850-217-7643"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "308 MIRACLE STRIP PKWY SW",
            "city": "FORT WALTON BEACH",
            "state": "FL",
            "postal_code": "325485217",
            "telephone_number": "850-217-7643"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5747 E Bay Blvd",
            "address_purpose": "LOCATION",
            "city": "Gulf Breeze",
            "state": "FL",
            "postal_code": "325639665",
            "country_code": "US",
            "telephone_number": "850-307-8811",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MARKS",
        "first_name": "RUTH-ALEXANDRIA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-05-19",
        "last_updated": "2021-06-23",
        "certification_date": "2021-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "222Q00000X",
            "taxonomy_group": "",
            "desc": "Developmental Therapist",
            "state": "FL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Walton Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2021; 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.