Active NPI
Brenda Green Marvel, OTR
- Contractor
- Copley, OH
National Provider Identifier
1912075888
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Contractor
- License
- 1755
- Practice address
- 4265 Ridge Crest Dr
Copley, OH 44321-3067 - Phone
- (330) 670-0776
- NPI assigned
- Dec 1, 2006
- Last updated
- Jul 8, 2007
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Contractor | 171W00000X | 1755 | OH | Primary |
Addresses
Primary practice location
4265 Ridge Crest Dr
Copley, OH 44321-3067
Mailing address
4265 Ridge Crest Dr
Copley, OH 44321-3067
Phone (330) 670-0776
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1755 | OH | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1164931200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1912075888",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4265 RIDGE CREST DR",
"city": "COPLEY",
"state": "OH",
"postal_code": "443213067",
"telephone_number": "330-670-0776"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4265 RIDGE CREST DR",
"city": "COPLEY",
"state": "OH",
"postal_code": "443213067",
"telephone_number": "330-670-0776"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARVEL",
"first_name": "BRENDA",
"middle_name": "GREEN",
"credential": "OTR",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-12-01",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "171W00000X",
"taxonomy_group": "",
"desc": "Contractor",
"state": "OH",
"license": "1755",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Copley, OH
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.