Marissa Jenkins, SFIDC

Primary specialty

Independent Duty CorpsmanTaxonomy code 1710I1002X

Practice address

504 Meade Dr
Coraopolis, PA 15108-9639

Phone

(412) 715-5590

NPI assigned

Nov 7, 2022

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1667779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667779200000",
    "number": "1134837446",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "504 MEADE DR",
            "city": "CORAOPOLIS",
            "state": "PA",
            "postal_code": "151089639",
            "telephone_number": "412-715-5590"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "504 MEADE DR",
            "city": "CORAOPOLIS",
            "state": "PA",
            "postal_code": "151089639",
            "telephone_number": "412-715-5590"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JENKINS",
        "first_name": "MARISSA",
        "credential": "SFIDC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-11-07",
        "last_updated": "2022-11-07",
        "certification_date": "2022-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1710I1002X",
            "taxonomy_group": "",
            "desc": "Military Health Care Provider, Independent Duty Corpsman",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• David A Iurlano, DMD
• James D Harkins DMD LTD
• Jacqueline Annette James
• Jan W. Maratta, M.D. LTD.
• George Janusz
• Parviz Jian, MD
• Tommisina Victoria Johnson, LPN
• Dayna Michal Jones, M.S., CCC-SLP
• Lindsay M Jones, PA-C
• Judy L. Disanti, DMD LLC

• Independent Duty Corpsman in Coraopolis, PA
• Providers in Coraopolis, PA by specialty
• Independent Duty Corpsman in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2022; 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.