Marina Sidra Gerges

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

License

11020796A Issued in IN

Practice address

966 Bartley St
Jasper, IN 47546-2641

Phone

(812) 996-5425

NPI assigned

Jul 3, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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

State licenses

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

{
    "created_epoch": "1562112000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1562544000000",
    "number": "1053973636",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "515 W 9TH STREET",
            "address_2": "UNIT A",
            "city": "JASPER",
            "state": "IN",
            "postal_code": "47546",
            "telephone_number": "513-546-3224"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "966 BARTLEY ST",
            "city": "JASPER",
            "state": "IN",
            "postal_code": "475462641",
            "telephone_number": "812-996-5425"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIDRA GERGES",
        "first_name": "MARINA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-03",
        "last_updated": "2019-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "11020796A",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "IN",
            "license": "11020796A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kendall Renee Sermerseim
• Miranda Sermersheim, OT
• Shad M. Huffer, P.C.
• Alisha Shake, MD
• Devdas N. Sheth, M.D.
• Ava Elizabeth Sinclair
• Sleep Management Institute LLC
• Sleep Management Institute LLC
• Amanda Jo Smith-Bradway, D.C
• Karen Smith, NP

• Student in an Organized Health Care Education/Training Program in Jasper, IN
• Providers in Jasper, IN by specialty
• Student in an Organized Health Care Education/Training Program in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2019; 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.