James G Marencik, MD

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

01051630 Issued in IN

Practice address

645 S Rogers St
Bloomington, IN 47403-2353

Phone

(812) 339-1691

Fax

(812) 339-8109

NPI assigned

Dec 7, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1133913600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560729600000",
    "number": "1043295694",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "645 S ROGERS ST",
            "city": "BLOOMINGTON",
            "state": "IN",
            "postal_code": "474032353",
            "telephone_number": "812-339-1691",
            "fax_number": "812-337-2438"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "645 S ROGERS ST",
            "city": "BLOOMINGTON",
            "state": "IN",
            "postal_code": "474032353",
            "telephone_number": "812-339-1691",
            "fax_number": "812-339-8109"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARENCIK",
        "first_name": "JAMES",
        "middle_name": "G",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-07",
        "last_updated": "2019-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "IN",
            "license": "01051630",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "IN",
            "license": "01051630",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200261970A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Alex Manuel, MD
• Bettina R Manuel, CCC-SLP
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• Marc J Meadows DDS PC
• Nicole Mardirossian
• Heather Leigh Maritano, LCSW, RPT-S
• Mark a. Herrmann, PH.D., P.C.
• Valerie Markley, DNP, PMHCNS-BC
• Charlotte I Marks, PA
• Emma Marschel, RBT

• Psychiatry Physician in Bloomington, IN
• Providers in Bloomington, IN by specialty
• Psychiatry Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2019; 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.