Individual provider Active NPI

Lauren Nicole Marshall, FNP

  • Nurse Practitioner
  • Belleville, IL
National Provider Identifier
1003373200
Registry record updated Dec 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
2019005033 Issued in MO
Practice address
4500 Memorial Dr
Belleville, IL 62226-5360
Phone
(618) 257-5455
Fax
(618) 257-4490
NPI assigned
Feb 23, 2019
Last updated
Dec 6, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 6, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 2019005033 MO Primary
Family Nurse Practitioner 363LF0000X 2019005033 MO
Family Nurse Practitioner 363LF0000X 041427324 IL

Addresses

Primary practice location

4500 Memorial Dr
Belleville, IL 62226-5360

Mailing address

4500 Memorial Dr
Belleville, IL 62226-5360
Phone (618) 257-5455

Other identifiers 2

IdentifierTypeStateIssuer
420075085MedicaidMO
401027711MedicaidIL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, MO2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20190501002277 IL Practitioner - Nurse Practitioner 2365784980 Reassigns benefits to 1 organization
I20191016002122 MO Practitioner - Nurse Practitioner 2365784980 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Galen Inpatient Physicians PCGroup PAC ID 3678464633, 1,045 clinicians
Cep America LLCGroup PAC ID 6608056171, 995 clinicians

Practice addresses (Care Compare)

1015 Bowles Ave
Fenton, MO 63026-2394
Phone (636) 496-2000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
82.4 of 100Reported as group
Quality
65.6
Improvement activities
40
Cost
71.06

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
2019005033MOMDNurse Practitioner
041427324ILMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Southeastern Physician Services PC Nurse Practitioner CurrentSince Jun 1, 2024 Accepting new patients
Cep America LLC CurrentSince Aug 15, 2025 Accepting new patients
Southeastern Emergency Services of Memphis, P.C. Nurse Practitioner CurrentSince Oct 9, 2023 Accepting new patients
Emergency Services Midwest SC Nurse Practitioner CurrentSince Oct 9, 2023 Accepting new patients
Galen Inpatient Physicians PC CurrentSince Oct 15, 2024 Accepting new patients
Southeastern Emergency Physicians of Memphis LLC Nurse Practitioner CurrentSince Aug 1, 2024 Accepting new patients
Galen Inpatient Physicians PC. CurrentSince Oct 15, 2024 Accepting new patients
Cep America, LLC Current Accepting new patients
Cep America LLC CurrentSince Aug 15, 2025 Accepting new patients
Our Urgent Care, LLC CurrentSince Jul 1, 2020 Accepting new patients

Locations

2100 Powell St
Ste 400
Emeryville, CA 94608
Phone (510) 350-2638

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 350-2663

4500 Memorial Dr
Belleville, IL 62226
Phone (618) 233-7750

1600 E Broadway
Columbia, MO 65201
Phone (573) 632-5000

1015 Bowles Ave
Fenton, MO 63026
Phone (636) 496-2000

1225 Graham Rd
Florissant, MO 63031
Phone (314) 653-5630

2893 Veterans Memorial Pkwy
Saint Charles, MO 63303
Phone (636) 724-1100

11133 Dunn Rd
Saint Louis, MO 63136
Phone (314) 653-5000

10 Hospital Dr
Saint Peters, MO 63376
Phone (636) 394-2522

3195 Phoenix Center Dr
Washington, MO 63090
Phone (636) 231-5623

1111 W Pearce Blvd
Wentzville, MO 63385
Phone (636) 856-5362

Organizations & group practices 10

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1550880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733443200000",
    "number": "1003373200",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4500 MEMORIAL DR",
            "city": "BELLEVILLE",
            "state": "IL",
            "postal_code": "622265360",
            "telephone_number": "618-257-5455",
            "fax_number": "618-257-4490"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4500 MEMORIAL DR",
            "city": "BELLEVILLE",
            "state": "IL",
            "postal_code": "622265360",
            "telephone_number": "618-257-5455",
            "fax_number": "618-257-4490"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARSHALL",
        "first_name": "LAUREN",
        "middle_name": "NICOLE",
        "name_prefix": "Ms.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-02-23",
        "last_updated": "2024-12-06",
        "certification_date": "2024-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MO",
            "license": "2019005033",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2019005033",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "041427324",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "420075085",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "401027711",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Belleville, IL

Sources for this page

Verify at the official NPI Registry.