Marina Victorovna Nedospasova, NP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

1-138584 Issued in AL

Practice address

Winn Army Community Hospital
1061 Harmon Ave
Fort Stewart, GA 31314

Phone

(912) 435-5687

NPI assigned

Sep 16, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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

{
    "created_epoch": "1442361600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631232000000",
    "number": "1043689490",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "WINN ARMY COMMUNITY HOSPITAL",
            "address_2": "1061 HARMON AVE",
            "city": "FORT STEWART",
            "state": "GA",
            "postal_code": "31314",
            "telephone_number": "912-435-5687"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "WINN ARMY COMMUNITY HOSPITAL",
            "address_2": "1061 HARMON AVE",
            "city": "FORT STEWART",
            "state": "GA",
            "postal_code": "31314",
            "telephone_number": "912-435-5687"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEDOSPASOVA",
        "first_name": "MARINA",
        "middle_name": "VICTOROVNA",
        "name_prefix": "Ms.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-09-16",
        "last_updated": "2021-09-10",
        "certification_date": "2021-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "AL",
            "license": "1-138584",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "AP8698",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• James Myers
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• Krista Nadeau
• National Vision, Inc.
• Jocelyn Nava
• Glynis Neister, LPN
• Burton Todd Newman, D.O.
• Melyssa Newman, LCSW
• Trung-Viet Nguyen, RN
• Emma Nicholson I

• Nurse Practitioner in Fort Stewart, GA
• Providers in Fort Stewart, GA by specialty
• Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.