Individual provider Active NPI

Marni B. Barnes

  • Physician Assistant
  • Fort Campbell, KY
National Provider Identifier
1114020070
Registry record updated Oct 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
650 Joel Dr
Fort Campbell, KY 42223-5318
Phone
(270) 798-8727
NPI assigned
Sep 6, 2006
Last updated
Oct 10, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 10, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

650 Joel Dr
Fort Campbell, KY 42223-5318

Mailing address

650 Joel Dr
Attn: MCXD-DCCS-CR, Credentials Office
Fort Campbell, KY 42223
Phone (270) 798-8727

Other practice location 1

10755 Eagle Way Ste 200
Hopkinsville, KY 42240-8742
Phone (270) 889-0701

Other practice location 2

105 Keeton Dr
Hopkinsville, KY 42240-8756
Phone (270) 889-0701

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
Physician Assistant

NPI Registry JSON

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

{
    "created_epoch": "1157500800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728518400000",
    "number": "1114020070",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "650 JOEL DR",
            "address_2": "ATTN: MCXD-DCCS-CR, CREDENTIALS OFFICE",
            "city": "FORT CAMPBELL",
            "state": "KY",
            "postal_code": "42223",
            "telephone_number": "270-798-8727",
            "fax_number": "270-798-8224"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "650 JOEL DR",
            "city": "FORT CAMPBELL",
            "state": "KY",
            "postal_code": "422235318",
            "telephone_number": "270-798-8727"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10755 Eagle Way Ste 200",
            "address_purpose": "LOCATION",
            "city": "Hopkinsville",
            "state": "KY",
            "postal_code": "422408742",
            "country_code": "US",
            "telephone_number": "270-889-0701",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "105 Keeton Dr",
            "address_purpose": "LOCATION",
            "city": "Hopkinsville",
            "state": "KY",
            "postal_code": "422408756",
            "country_code": "US",
            "telephone_number": "270-889-0701",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BARNES",
        "first_name": "MARNI",
        "middle_name": "B.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-06",
        "last_updated": "2024-10-10",
        "certification_date": "2024-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Campbell, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2024; 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.