Active NPI
Beverly Jean Marzell, PATIENT CARE TECH
- Personal Care Attendant
- College Park, GA
National Provider Identifier
1912202920
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Personal Care Attendant
- License
- 3747P1801X
- Practice address
- 325 Marley Dr
College Park, GA 30349-7101 - Phone
- (770) 994-9243
- NPI assigned
- Jan 22, 2011
- Last updated
- Jan 22, 2011
- 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 |
|---|---|---|---|---|
| Personal Care Attendant | 3747P1801X | 3747P1801X | GA | Primary |
Addresses
Primary practice location
325 Marley Dr
College Park, GA 30349-7101
Mailing address
325 Marley Dr
College Park, GA 30349-7101
Phone (770) 994-9243
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 |
|---|---|---|---|
| 3747P1801X | GA | MD | Personal Care Attendant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1295654400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1295654400000",
"number": "1912202920",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "325 MARLEY DR",
"city": "COLLEGE PARK",
"state": "GA",
"postal_code": "303497101",
"telephone_number": "770-994-9243"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "325 MARLEY DR",
"city": "COLLEGE PARK",
"state": "GA",
"postal_code": "303497101",
"telephone_number": "770-994-9243"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARZELL",
"first_name": "BEVERLY",
"middle_name": "JEAN",
"name_prefix": "Ms.",
"credential": "PATIENT CARE TECH",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-01-22",
"last_updated": "2011-01-22",
"status": "A"
},
"taxonomies": [
{
"code": "3747P1801X",
"taxonomy_group": "",
"desc": "Technician, Personal Care Attendant",
"state": "GA",
"license": "3747P1801X",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in College Park, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 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.