Active NPI
Marc David Herbert
- Physical Therapist
- Kennesaw, GA
National Provider Identifier
1912426875
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- Practice address
- 1615 Ridenour Blvd NW Ste 204
Kennesaw, GA 30152-4464 - Phone
- (770) 580-8070
- NPI assigned
- Sep 12, 2017
- 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 Therapist | 225100000X | Primary |
Addresses
Primary practice location
1615 Ridenour Blvd NW Ste 204
Kennesaw, GA 30152-4464
Mailing address
PO Box 441146
Kennesaw, GA 30160-9522
Phone (678) 403-3568
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in GA
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| PT Solutions of Acworth LLC | Physical Therapist | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Physical Therapist
- Kennesaw, GA
- NPI 1184075210
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1505174400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1505174400000",
"number": "1912426875",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 441146",
"city": "KENNESAW",
"state": "GA",
"postal_code": "301609522",
"telephone_number": "678-403-3568"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1615 RIDENOUR BLVD NW STE 204",
"city": "KENNESAW",
"state": "GA",
"postal_code": "301524464",
"telephone_number": "770-580-8070"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HERBERT",
"first_name": "MARC",
"middle_name": "DAVID",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-09-12",
"last_updated": "2017-09-12",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Kennesaw, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.