Individual provider Active NPI

Marisa Ann Herrera, NP

  • Family Nurse Practitioner
  • Norton Shores, MI
National Provider Identifier
1053586255
Registry record updated Apr 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
4704233226 Issued in MI
Practice address
4905 Harvey St
Norton Shores, MI 49444-9763
Phone
(231) 655-3284
Fax
(231) 655-5040
NPI assigned
Apr 28, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 11, 2025

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 4704233226 MI Primary

Addresses

Primary practice location

4905 Harvey St
Norton Shores, MI 49444-9763

Mailing address

4905 Harvey St
Norton Shores, MI 49444-9763
Phone (231) 655-3284

Other practice location 1

2608 Government Center Dr
Manistee, MI 49660-8302
Phone (231) 398-6601

Other names 1

  • Marisa Barco Former name

Medicare participation

Medicare enrollment files
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.

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4704233226MIMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Little River Band of Ottawa Indians CurrentSince Apr 13, 2025 Accepting new patients

Locations

4905 Harvey St
Norton Shores, MI 49444
Phone (231) 655-3284

Organizations & group practices 1

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": "1209340800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744329600000",
    "number": "1053586255",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4905 HARVEY ST",
            "city": "NORTON SHORES",
            "state": "MI",
            "postal_code": "494449763",
            "telephone_number": "231-655-3284",
            "fax_number": "231-655-5040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4905 HARVEY ST",
            "city": "NORTON SHORES",
            "state": "MI",
            "postal_code": "494449763",
            "telephone_number": "231-655-3284",
            "fax_number": "231-655-5040"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2608 Government Center Dr",
            "address_purpose": "LOCATION",
            "city": "Manistee",
            "state": "MI",
            "postal_code": "496608302",
            "country_code": "US",
            "telephone_number": "231-398-6601",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HERRERA",
        "first_name": "MARISA",
        "middle_name": "ANN",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-04-28",
        "last_updated": "2025-04-11",
        "certification_date": "2025-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704233226",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARISA",
            "last_name": "BARCO",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Norton Shores, MI

Sources for this page

Verify at the official NPI Registry.