Marisa L Crenshaw, APRN

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

3007792 Issued in KY

Practice address

5722 Outer Loop
Louisville, KY 40219-4156

Phone

(502) 921-0222

Fax

(502) 921-0222

NPI assigned

May 12, 2008

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in KY, IN, OR3 enrollments

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 3

Specialty

Nurse Practitioner

Education

Vanderbilt University School of Medicine, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Nulease Medical Solutions LLCGroup PAC ID 7618211434, 5 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts, Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mcrenshaw41708@direct.nortonhealthcare.org

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.

• Nulease Medical Solutions LLC

  • Addiction Medicine (Family Medicine) Physician
  • Louisville, KY
  • NPI 1194254219
  Medicare reassignment Care Compare group NPD
• Fanno Creek Clinic LLC

  • Internal Medicine Physician
  • Portland, OR
  • NPI 1609876705
  Medicare reassignment NPD
• Norton Hospitals Inc

  • Multi-Specialty Clinic/Center
  • Louisville, KY
  • NPI 1073568879

  IN

  Medicare reassignment
• Nulease Medical Solutions LLC

  • Clinical Medical Laboratory
  • Louisville, KY
  • NPI 1184297483
  NPD
• Nulease Medical Solutions LLC

  • Addiction Medicine (Internal Medicine) Physician
  • Campbellsville, KY
  • NPI 1861024424
  NPD
• Lifespan Behavioral Health, LLC

  • Clinical Psychologist
  • Mesa, AZ
  • NPI 1033229281
  NPD (past)

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

{
    "created_epoch": "1210550400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698883200000",
    "number": "1124295852",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5722 OUTER LOOP",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402194156",
            "telephone_number": "502-921-0222",
            "fax_number": "502-921-0222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5722 OUTER LOOP",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402194156",
            "telephone_number": "502-921-0222",
            "fax_number": "502-921-0222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRENSHAW",
        "first_name": "MARISA",
        "middle_name": "L",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-05-12",
        "last_updated": "2023-11-02",
        "certification_date": "2023-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "KY",
            "license": "3007792",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100230720",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201258840",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Carla M. Creekmore, C.R.N.P
• Joseph J Creely III, MD
• Aimee Creger
• Katherine Cregor, APRN
• Ashton Laine Crenshaw, BS, RBT
• Marylynn K Crenshaw, FNP, PMHNP
• Nicole S Crenshaw, LCSW
• Laikyn Creque, PA-C
• Marilyn Diane Crews, LCSW
• Melissa Katherine Crews, PHARMD, MBA

• Psychiatric/Mental Health Nurse Practitioner in Louisville, KY
• Providers in Louisville, KY by specialty
• Psychiatric/Mental Health Nurse Practitioner in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.