Active NPI
Paul Lance Marlowe, MD
- Family Medicine Physician
- Stateline, NV
National Provider Identifier
1124025069
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 4862
- Practice address
- 155 Hwy 50
Stateline, NV 89449 - Phone
- (775) 589-8900
- Fax
- (775) 588-7110
- NPI assigned
- Jul 7, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 4862 | NV | Primary |
| Family Medicine Physician | 207Q00000X | A39910 | CA |
Addresses
Primary practice location
155 Hwy 50
Stateline, NV 89449
Mailing address
1111 Emerald Bay Rd
South Lake Tahoe, CA 96150-6207
Phone (530) 543-5659
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
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A39910 | CA | MD | Family Medicine Physician |
| 4862 | NV | MD | Family Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1120694400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1405468800000",
"number": "1124025069",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1111 EMERALD BAY RD",
"city": "SOUTH LAKE TAHOE",
"state": "CA",
"postal_code": "961506207",
"telephone_number": "530-543-5659",
"fax_number": "530-541-8723"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "155 HWY 50",
"city": "STATELINE",
"state": "NV",
"postal_code": "89449",
"telephone_number": "775-589-8900",
"fax_number": "775-588-7110"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARLOWE",
"first_name": "PAUL",
"middle_name": "LANCE",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-07-07",
"last_updated": "2014-07-16",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "NV",
"license": "4862",
"primary": true
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "CA",
"license": "A39910",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Stateline, NV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.