NPIMap

Individual provider Active NPI

Erica Gail Marriott, FNP-C

  • Family Nurse Practitioner
  • Willow Springs, MO
National Provider Identifier
1104345842
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
2017035199 Issued in MO
Practice address
1202 E Main St
Willow Springs, MO 65793-3588
Phone
(417) 469-1820
NPI assigned
Sep 13, 2017
Last updated
Jul 21, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 2017035199 MO Primary
Registered Nurse 163W00000X 2003015908 MO

Addresses

Primary practice location

1202 E Main St
Willow Springs, MO 65793-3588

Mailing address

1202 E Main St
Willow Springs, MO 65793-3588
Phone (417) 469-1820

Other identifiers 2

IdentifierTypeStateIssuer
2003015908OtherMOMISSOURI STATE BOARD OF NURSING REGISTERED NURSE
F09171097OtherAMERICAN ACADEMY OF NURSE PRACTITIONERS CERTIFICAN BOARD FAMILY NURSE PRACTITION

Other names 1

  • Erica Gail Lovorn, Hayhurst Buckner Mendenhall Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171005002430 MO Practitioner - Nurse Practitioner 0244505949 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy Clinic Springfield CommunitiesGroup PAC ID 7416865845, shared by 26 NPIs, 1,121 clinicians

Practice addresses (Care Compare)

104 E US Hwy 60
MC Family Medicine Mountain View
Mountain View, MO 65548-7381
Phone (417) 934-2251

1202 E Main St
MC Family Medicine Willow Springs
Willow Springs, MO 65793-3588
Phone (417) 469-1820

1605 Martin Springs Dr
Rolla, MO 65401-2980

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2003015908MOMDRegistered Nurse
2017035199MOMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Clinic Springfield Communities CurrentSince Feb 5, 2018 Accepting new patients
Mercy Clinic Springfield Communities Family CurrentSince Oct 22, 2017 Accepting new patients
Ozarks Medical Center Past Accepting new patients

Locations

1605 Martin Springs Dr
Rolla, MO 65401
Phone (573) 458-6379

1605 Martin Springs Dr
Ste 330
Rolla, MO 65401
Phone (573) 458-6379

2115 S Fremont Ave
Ste 3050
Springfield, MO 65804
Phone (417) 820-3905

1202 E Main St
Willow Springs, MO 65793
Phone (417) 293-7184

Interoperability endpoints

  • Direct secure messaging: emarriott163302@directc.mercy.net

Organizations & group practices 3

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.

Hospital & facility affiliations 12

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1505260800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1104345842",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1202 E MAIN ST",
            "city": "WILLOW SPRINGS",
            "state": "MO",
            "postal_code": "657933588",
            "telephone_number": "417-469-1820"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1202 E MAIN ST",
            "city": "WILLOW SPRINGS",
            "state": "MO",
            "postal_code": "657933588",
            "telephone_number": "417-469-1820"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARRIOTT",
        "first_name": "ERICA",
        "middle_name": "GAIL",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-09-13",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2017035199",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MO",
            "license": "2003015908",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MISSOURI STATE BOARD OF NURSING REGISTERED NURSE",
            "identifier": "2003015908",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERICAN ACADEMY OF NURSE PRACTITIONERS CERTIFICAN BOARD FAMILY NURSE PRACTITION",
            "identifier": "F09171097",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ERICA",
            "last_name": "LOVORN, HAYHURST BUCKNER MENDENHALL",
            "middle_name": "GAIL",
            "credential": "RN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Willow Springs, MO

Sources for this page

Verify at the official NPI Registry.