Active NPI
Marlyn C Teague, NP
- Family Nurse Practitioner
- Raleigh, NC
National Provider Identifier
1093794679
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- F0303059
- Practice address
- 12108 Ranleigh CT
Raleigh, NC 27613-5525 - Phone
- (919) 846-6625
- NPI assigned
- Jan 12, 2006
- Last updated
- May 2, 2008
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | F0303059 | NC | Primary |
Addresses
Primary practice location
12108 Ranleigh CT
Raleigh, NC 27613-5525
Mailing address
12108 Ranleigh CT
Raleigh, NC 27613-5525
Phone (919) 846-6625
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| F0303059 | NC | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Physicians Eldercare PA | Past | Accepting new patients | |
| Independence Medical, PA | Past | Accepting new patients |
Interoperability endpoints
- https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
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- NPI 1700845112
-
- General Practice Physician
- Durham, NC
- NPI 1023083268
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1137024000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1209686400000",
"number": "1093794679",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12108 RANLEIGH CT",
"city": "RALEIGH",
"state": "NC",
"postal_code": "276135525",
"telephone_number": "919-846-6625"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12108 RANLEIGH CT",
"city": "RALEIGH",
"state": "NC",
"postal_code": "276135525",
"telephone_number": "919-846-6625"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TEAGUE",
"first_name": "MARLYN",
"middle_name": "C",
"credential": "NP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-01-12",
"last_updated": "2008-05-02",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "NC",
"license": "F0303059",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Raleigh, NC
- Teaching Alternative Strategies and Knowledge Incorporated (TasK Inc)
- Clara Jo Teague, LCAS
- Hayley York Teague, MA, NCC, LPCA
- Kimberly Elizabeth Teague, FNP
- Malinda Teague, CPNP
- Christina Nicole Teal
- Team Chiropractic & Sports Medicine, PA
- James Douglas Teasdall
- Myra Lynn Teasley, M.D.
- Victor Teasley, CPSS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.