Active NPI
Janelle Marie Marra, DO
- Family Medicine Physician
- Twentynine Palms, CA
National Provider Identifier
1003070467
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 20A11137
- Practice address
- 1145 Sturgis Road
Magtftc McAgcc
Twentynine Palms, CA 92278-8250 - Phone
- (760) 830-2190
- NPI assigned
- Jul 15, 2008
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 20A11137 | CA | Primary |
Addresses
Primary practice location
1145 Sturgis Road
Magtftc McAgcc
Twentynine Palms, CA 92278-8250
Mailing address
Box 788250
Magtftc McAgcc
Twentynine Palms, CA 92278-8250
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
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 20A11137 | CA | MD | Family Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1216080000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1313712000000",
"number": "1003070467",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "BOX 788250",
"address_2": "MAGTFTC MCAGCC",
"city": "TWENTYNINE PALMS",
"state": "CA",
"postal_code": "922788250"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1145 STURGIS ROAD",
"address_2": "MAGTFTC MCAGCC",
"city": "TWENTYNINE PALMS",
"state": "CA",
"postal_code": "922788250",
"telephone_number": "760-830-2190"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARRA",
"first_name": "JANELLE",
"middle_name": "MARIE",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-07-15",
"last_updated": "2011-08-19",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "CA",
"license": "20A11137",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Twentynine Palms, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 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.