Individual provider Active NPI

Shirley Alice Marineau, MD

  • Pediatric Adolescent Medicine Physician
  • Naples, FL
National Provider Identifier
1104861939
Registry record updated Aug 23, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Adolescent Medicine PhysicianTaxonomy code 2080A0000X
License
ME48023 Issued in FL
Practice address
2336 Immokalee Rd
Naples, FL 34110-1414
Phone
(239) 591-8481
Fax
(239) 596-0212
NPI assigned
Jun 17, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 23, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Adolescent Medicine Physician 2080A0000X ME48023 FL Primary

Addresses

Primary practice location

2336 Immokalee Rd
Naples, FL 34110-1414

Mailing address

2336 Immokalee Rd
Naples, FL 34110-1414
Phone (239) 591-8481

Other identifiers 1

IdentifierTypeStateIssuer
47177100MedicaidFL

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)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME48023FLMDPediatric Adolescent Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Diana McLaughlin, M.D., PA Adolescent Medicine Past Accepting new patients

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": "1150502400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1314057600000",
    "number": "1104861939",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2336 IMMOKALEE RD",
            "city": "NAPLES",
            "state": "FL",
            "postal_code": "341101414",
            "telephone_number": "239-591-8481",
            "fax_number": "239-596-0212"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2336 IMMOKALEE RD",
            "city": "NAPLES",
            "state": "FL",
            "postal_code": "341101414",
            "telephone_number": "239-591-8481",
            "fax_number": "239-596-0212"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARINEAU",
        "first_name": "SHIRLEY",
        "middle_name": "ALICE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-17",
        "last_updated": "2011-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080A0000X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": "FL",
            "license": "ME48023",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "47177100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Naples, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.