Active NPI
Marissa F Kleffman Underwood, ARNP
- Family Nurse Practitioner
- Greenville, NC
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 264412
- Practice address
- 1204 E Fire Tower Rd
Greenville, NC 27858-4196 - Phone
- (252) 744-1122
- Fax
- (252) 744-1133
- NPI assigned
- Oct 12, 2015
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 5008128 | NC | |
| Family Nurse Practitioner | 363LF0000X | 264412 | NC | Primary |
| Nurse Practitioner | 363L00000X | ARNP9467370 | FL |
Addresses
Primary practice location
1204 E Fire Tower Rd
Greenville, NC 27858-4196
Mailing address
PO Box 751069
Charlotte, NC 28275-1069
Other practice location 1
4500 San Pablo Rd S
Jacksonville, FL 32224-1865
Phone (904) 953-2000
Other practice location 2
381 Ruin Creek Rd
Henderson, NC 27536-2932
Phone (252) 430-0666 ext. 417
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 19GSY | Other | BCBS OF NC | |
| 1144691528 | Medicaid | NC | |
| NCR001B | Other | NC | MEDICARE |
Other names 1
- Marissa F Kleffman
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | mkleffmanunderwood283066@direct.ecuhealth.com | Health Information Exchange (HIE) |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NC
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2015
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
1204 E Fire Tower Rd
Greenville, NC 27858-4196
Phone (252) 744-1122
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ARNP9467370 | FL | MD | Nurse Practitioner |
| 5008128 | NC | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| East Carolina University | Current | Accepting new patients | |
| Vance Family Medicine, PA | Current | Accepting new patients | |
| East Carolina University | Current | Accepting new patients | |
| East Carolina University | Past | Accepting new patients |
Locations
600 Moye Blvd
Greenville, NC 27834
Phone (252) 744-1111
1204 E Fire Tower Rd
Greenville, NC 27858
Phone (252) 744-1122
381 Ruin Creek Rd
Henderson, NC 27536
Phone (252) 430-0666
Organizations & group practices 4
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Rural Health Clinic/Center
- Henderson, NC
- NPI 1619938479
-
- Internal Medicine Physician
- Greenville, NC
- NPI 1043260474
-
dba ECU Physicians
- Obstetrics & Gynecology Physician
- Greenville, NC
- NPI 1528016938
Hospital & facility affiliations 3
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba CenterWell Home Health
- Home Health Agency
- Greenville, NC
- NPI 1396775136
-
dba ECU Health Beaufort Hospital-a campus of ECU Health Medical Center
- General Acute Care Hospital
- Washington, NC
- NPI 1780359687
-
dba ECU Health Medical Center
- General Acute Care Hospital
- Greenville, NC
- NPI 1043218944
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1444608000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1708041600000",
"number": "1144691528",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 751069",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282751069"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1204 E FIRE TOWER RD",
"city": "GREENVILLE",
"state": "NC",
"postal_code": "278584196",
"telephone_number": "252-744-1122",
"fax_number": "252-744-1133"
}
],
"practiceLocations": [
{
"address_1": "4500 San Pablo Rd S",
"address_purpose": "LOCATION",
"city": "Jacksonville",
"state": "FL",
"postal_code": "322241865",
"country_code": "US",
"telephone_number": "904-953-2000",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "381 Ruin Creek Rd",
"address_purpose": "LOCATION",
"city": "Henderson",
"state": "NC",
"postal_code": "275362932",
"country_code": "US",
"telephone_number": "252-430-0666 x417",
"fax_number": "252-430-7503",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "KLEFFMAN UNDERWOOD",
"first_name": "MARISSA",
"middle_name": "F",
"credential": "ARNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-10-12",
"last_updated": "2024-02-16",
"certification_date": "2024-02-16",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "NC",
"license": "5008128",
"primary": false
},
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "NC",
"license": "264412",
"primary": true
},
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "FL",
"license": "ARNP9467370",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS OF NC",
"identifier": "19GSY",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1144691528",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE",
"identifier": "NCR001B",
"state": "NC"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "mkleffmanunderwood283066@direct.ecuhealth.com",
"affiliation": "N",
"endpointDescription": "ECU Physicians",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"address_1": "1204 E Fire Tower Rd",
"city": "Greenville",
"state": "NC",
"country_code": "US",
"postal_code": "278584196",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": [
{
"first_name": "MARISSA",
"last_name": "KLEFFMAN",
"middle_name": "F",
"code": "1",
"type": "Former Name"
}
]
}
Other providers in Greenville, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2024; 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.