Individual provider Active NPI

Marie Jose Noel

  • Family Nurse Practitioner
  • Lake Worth, FL
National Provider Identifier
1104474535
Registry record updated Jul 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN9340701 Issued in FL
Practice address
5029 Forest Dale Dr
Lake Worth, FL 33449-4626
Phone
(561) 577-0446
NPI assigned
Aug 28, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X APRN9340701 FL
Family Nurse Practitioner 363LF0000X APRN9340701 FL Primary

Addresses

Primary practice location

5029 Forest Dale Dr
Lake Worth, FL 33449-4626

Mailing address

5029 Forest Dale Dr
Lake Worth, FL 33449-4626
Phone (561) 577-0446

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250105000017 FL Practitioner - Nurse Practitioner 3173051125

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
APRN9340701FLMDFamily Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1566950400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722211200000",
    "number": "1104474535",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5029 FOREST DALE DR",
            "city": "LAKE WORTH",
            "state": "FL",
            "postal_code": "334494626",
            "telephone_number": "561-577-0446"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5029 FOREST DALE DR",
            "city": "LAKE WORTH",
            "state": "FL",
            "postal_code": "334494626",
            "telephone_number": "561-577-0446"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOEL",
        "first_name": "MARIE",
        "middle_name": "JOSE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-08-28",
        "last_updated": "2024-07-29",
        "certification_date": "2024-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "FL",
            "license": "APRN9340701",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN9340701",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Worth, FL

Sources for this page

Verify at the official NPI Registry.