Individual provider Active NPI

Mairlyn Jemison, PTA

  • Physical Therapy Assistant
  • Milwaukee, WI
National Provider Identifier
1962580845
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
468-019 Issued in WI
Practice address
1000 N 92ND St
Milwaukee, WI 53226-3533
Phone
(414) 479-9218
Fax
(414) 479-9227
NPI assigned
Nov 1, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 468-019 WI Primary

Addresses

Primary practice location

1000 N 92ND St
Milwaukee, WI 53226-3533

Mailing address

3217A N 12TH St
Milwaukee, WI 53206-2755
Phone (414) 263-2606

Other names 1

  • Marilyn Calmese Former name

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

LicenseStateTypeSpecialty
468-019WIMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1962580845",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3217A N 12TH ST",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532062755",
            "telephone_number": "414-263-2606",
            "fax_number": "414-479-9227"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 N 92ND ST",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532263533",
            "telephone_number": "414-479-9218",
            "fax_number": "414-479-9227"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JEMISON",
        "first_name": "MAIRLYN",
        "credential": "PTA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "WI",
            "license": "468-019",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARILYN",
            "last_name": "CALMESE",
            "credential": "PTA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Milwaukee, WI

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.

Verify at the official NPI Registry.