Individual provider Active NPI

Mary Ann Marrs, CNP

  • Clinical Nurse Specialist
  • Rapid City, SD
National Provider Identifier
1144201708
Registry record updated Dec 6, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Nurse SpecialistTaxonomy code 364S00000X
License
SD-CNP CP000412 Issued in SD
Practice address
7220 S Highway 16
Rapid City, SD 57702-8708
Phone
(605) 341-1414
Fax
(605) 341-7062
NPI assigned
Nov 10, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 6, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X R029403 SD
Clinical Nurse Specialist 364S00000X SD-CNP CP000412 SD Primary

Addresses

Primary practice location

7220 S Highway 16
Rapid City, SD 57702-8708

Mailing address

7220 S Highway 16
PO Box 6850
Rapid City, SD 57702-8708
Phone (605) 341-1414

Other identifiers 3

IdentifierTypeStateIssuer
P00427538OtherMEDICARE RAILROAD PTAN
1254560001OtherSDCIGNA MEDICARE
6827452MedicaidSD

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
Certified Nurse Practitioner, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
SD-CNP CP000412SDMDClinical Nurse Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
Black Hills Orthopedic & Spine Center, Inc. PastSince Feb 28, 2011 Accepting new patients
Black Hills Hospitalist Past Accepting new patients
Rushmore Clinic, P.C. Past Accepting new patients

Interoperability endpoints

  • FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.140.71180

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1131580800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1354752000000",
    "number": "1144201708",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7220 S HIGHWAY 16",
            "address_2": "PO BOX 6850",
            "city": "RAPID CITY",
            "state": "SD",
            "postal_code": "577028708",
            "telephone_number": "605-341-1414",
            "fax_number": "605-341-7062"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7220 S HIGHWAY 16",
            "city": "RAPID CITY",
            "state": "SD",
            "postal_code": "577028708",
            "telephone_number": "605-341-1414",
            "fax_number": "605-341-7062"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARRS",
        "first_name": "MARY",
        "middle_name": "ANN",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-10",
        "last_updated": "2012-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "SD",
            "license": "R029403",
            "primary": false
        },
        {
            "code": "364S00000X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist",
            "state": "SD",
            "license": "SD-CNP CP000412",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD PTAN",
            "identifier": "P00427538",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA MEDICARE",
            "identifier": "1254560001",
            "state": "SD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6827452",
            "state": "SD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rapid City, SD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2012; 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.