Individual provider Active NPI

Marilyn Roberts

  • Family Nurse Practitioner
  • Lima, OH
National Provider Identifier
1033576525
Registry record updated Sep 17, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN.CNP.18763 Issued in OH
Practice address
375 N Eastown Rd Ste C
Lima, OH 45807-2209
Phone
(419) 224-4646
Fax
(419) 224-2410
NPI assigned
Jan 28, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X APRN.CNP.18763 OH Primary

Addresses

Primary practice location

375 N Eastown Rd Ste C
Lima, OH 45807-2209

Mailing address

1001 Bellefontaine Ave
Lima, OH 45804-2800
Phone (419) 998-4575

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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 1

Enrollment IDStateProvider typePAC IDDetails
I20160315000315 OH Practitioner - Nurse Practitioner 1759687924 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

525 N Eastown Rd
Lima, OH 45807-2268
Phone (419) 224-4646

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
APRN.CNP.18763OHMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Lima Memorial Professional Corporation CurrentSince Mar 1, 2016 Accepting new patients
Lima Memorial Professional Corporation Past Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients

Locations

L3982
Columbus, OH 43260

525 N Eastown Rd
Lima, OH 45807
Phone (419) 228-7275

525 N Eastown Rd
Ste 102
Lima, OH 45807
Phone (419) 998-8214

375 N Eastown Rd
Ste C
Lima, OH 45807
Phone (419) 222-6595

1001 Bellefontaine Ave
Lima, OH 45804
Phone (419) 228-3335

525 N Eastown Rd
Ste A
Lima, OH 45807
Phone (419) 224-4646

Interoperability endpoints

  • Direct secure messaging: marilyn.roberts@lmpc.eclinicaldirectplus.com

Organizations & group practices 3

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.

Hospital & facility affiliations 3

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": "1453939200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600300800000",
    "number": "1033576525",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 BELLEFONTAINE AVE",
            "city": "LIMA",
            "state": "OH",
            "postal_code": "458042800",
            "telephone_number": "419-998-4575",
            "fax_number": "419-998-4586"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "375 N EASTOWN RD STE C",
            "city": "LIMA",
            "state": "OH",
            "postal_code": "458072209",
            "telephone_number": "419-224-4646",
            "fax_number": "419-224-2410"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTS",
        "first_name": "MARILYN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-01-28",
        "last_updated": "2020-09-17",
        "certification_date": "2020-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "APRN.CNP.18763",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lima, OH

Sources for this page

Verify at the official NPI Registry.