Individual provider Active NPI

Marianna J Poulose, DO

  • Emergency Medicine Physician
  • Topeka, KS
National Provider Identifier
1023086824
Registry record updated Oct 27, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
529429 Issued in KS
Practice address
1700 SW 7TH St
Topeka, KS 66606-1674
Phone
(785) 295-5346
Fax
(785) 231-5930
NPI assigned
Mar 9, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 27, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 529429 KS Primary

Addresses

Primary practice location

1700 SW 7TH St
Topeka, KS 66606-1674

Mailing address

PO Box 1657
Topeka, KS 66601-1657
Phone (785) 295-8108

Other identifiers 1

IdentifierTypeStateIssuer
100412590FMedicaidKS

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)
Enrolled
Credentials
Doctor of Osteopathy, Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
529429KSMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St. Francis Physician Clinics Inc. Past Accepting new patients
Medevac Midamerica Inc Past Accepting new patients
Emergency Medicine Care LLC Emergency Medicine Past Accepting new patients
The Covenant Group PA Emergency Medicine Past Accepting new patients

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1141862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1256601600000",
    "number": "1023086824",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1657",
            "city": "TOPEKA",
            "state": "KS",
            "postal_code": "666011657",
            "telephone_number": "785-295-8108",
            "fax_number": "785-231-5991"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 SW 7TH ST",
            "city": "TOPEKA",
            "state": "KS",
            "postal_code": "666061674",
            "telephone_number": "785-295-5346",
            "fax_number": "785-231-5930"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POULOSE",
        "first_name": "MARIANNA",
        "middle_name": "J",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-09",
        "last_updated": "2009-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "KS",
            "license": "529429",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100412590F",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Topeka, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2009; 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.