NPIMap

Individual provider Active NPI

Adam Marshall, NP-C

  • Family Nurse Practitioner
  • Farmington, NM
National Provider Identifier
1124545744
Registry record updated Aug 24, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
CNP-03326 Issued in NM
Practice address
1001 W Broadway Ste D&E
Farmington, NM 87401-5638
Phone
(505) 327-4796
NPI assigned
Aug 24, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 24, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X CNP-03326 NM Primary

Addresses

Primary practice location

1001 W Broadway Ste D&E
Farmington, NM 87401-5638

Mailing address

1001 W Broadway Ste D&E
Farmington, NM 87401-5638
Phone (505) 327-4796

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM, TX2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20171009003187 NM Practitioner - Nurse Practitioner 6507994936 Reassigns benefits to 1 organization
I20220201000393 TX Practitioner - Nurse Practitioner 6507994936 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
DHHS PHS Naihs Shiprock Hospital 148 clinicians

Practice addresses (Care Compare)

6 Rd
Suite 7586
Bloomfield, NM 87413-4934
Phone (505) 368-6401

Hospital & facility affiliations

  • Northern Navajo Medical Center Hospital, Shiprock, NM, CCN 320059
  • San Juan Regional Medical Center Inc Hospital, Farmington, NM, CCN 320005

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
CNP-03326NMMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
DHHS, PHS, Naihs, Shiprock Hospital CurrentSince Jan 18, 2022 Accepting new patients
Presbyterian Medical Services Current Accepting new patients
Presbyterian Medical Services CurrentSince Oct 2, 2017 Accepting new patients
DHHS, PHS, Naihs, Shiprock Hospital CurrentSince Jan 18, 2022 Accepting new patients
Presbyterian Medical Services CurrentSince Oct 2, 2017 Accepting new patients
DHHS, PHS, Naihs, Shiprock Hospital Past Accepting new patients

Locations

6 Road 7586
Bloomfield, NM 87413
Phone (505) 368-8015

1001 W Broadway
Ste De
Farmington, NM 87401
Phone (505) 327-4796

1422 Paseo de Peralta
Santa Fe, NM 87501
Phone (505) 982-5565

Organizations & group practices 7

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.

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1503532800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1503532800000",
    "number": "1124545744",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 W BROADWAY STE D&E",
            "city": "FARMINGTON",
            "state": "NM",
            "postal_code": "874015638",
            "telephone_number": "505-327-4796"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 W BROADWAY STE D&E",
            "city": "FARMINGTON",
            "state": "NM",
            "postal_code": "874015638",
            "telephone_number": "505-327-4796"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARSHALL",
        "first_name": "ADAM",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-08-24",
        "last_updated": "2017-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NM",
            "license": "CNP-03326",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Farmington, NM

Sources for this page

Verify at the official NPI Registry.