Active NPI
Holly Beth Marvel, P.T.
- Physical Therapist
- Windham, CT
National Provider Identifier
1912247271
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 007495
- Practice address
- 103 North Rd
Windham, CT 06280-1311 - Phone
- (860) 423-4636
- NPI assigned
- Feb 25, 2013
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Geriatric Physical Therapist | 2251G0304X | |||
| Physical Therapist | 225100000X | 007495 | CT | Primary |
Addresses
Primary practice location
103 North Rd
Windham, CT 06280-1311
Mailing address
103 North Rd
Windham, CT 06280-1311
Phone (860) 423-4636
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 |
|---|---|---|---|
| 007495 | CT | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1361750400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1681689600000",
"number": "1912247271",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "103 NORTH RD",
"city": "WINDHAM",
"state": "CT",
"postal_code": "062801311",
"telephone_number": "860-423-4636"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "103 NORTH RD",
"city": "WINDHAM",
"state": "CT",
"postal_code": "062801311",
"telephone_number": "860-423-4636"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARVEL",
"first_name": "HOLLY",
"middle_name": "BETH",
"name_prefix": "Ms.",
"credential": "P.T.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-02-25",
"last_updated": "2023-04-17",
"certification_date": "2023-04-17",
"status": "A"
},
"taxonomies": [
{
"code": "2251G0304X",
"taxonomy_group": "",
"desc": "Physical Therapist, Geriatrics",
"state": null,
"license": null,
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "CT",
"license": "007495",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Windham, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.