Individual provider Active NPI

Marsha Kidder Rauch, A.R.N.P., PHD.

  • Gerontology Nurse Practitioner
  • Eustis, FL
National Provider Identifier
1164495396
Registry record updated Mar 18, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
ARNP518912 Issued in FL
Practice address
2000 Prevatt St
Suite B3
Eustis, FL 32726-6149
Phone
(407) 869-1450
Fax
(407) 574-4625
NPI assigned
Feb 8, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 18, 2014

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X ARNP518912 FL
Gerontology Nurse Practitioner 363LG0600X ARNP518912 FL Primary
Psychiatric/Mental Health Clinical Nurse Specialist 364SP0808X ARNP518912 FL

Addresses

Primary practice location

2000 Prevatt St
Suite B3
Eustis, FL 32726-6149

Mailing address

1450 West Lake Brantley Road
Longwood, FL 32779-4766
Phone (407) 869-1450

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
Nurse Practitioner, Doctor of Philosophy

Practice roles

OrganizationSpecialtyStatusNew patients
Marsha K. Rauch, PHD, Arnp Gerontology Past Accepting new patients
Florida Facilitists, LLC Past Accepting new patients

Organizations & group practices 2

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": "1139356800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1395100800000",
    "number": "1164495396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1450 WEST LAKE BRANTLEY ROAD",
            "city": "LONGWOOD",
            "state": "FL",
            "postal_code": "327794766",
            "telephone_number": "407-869-1450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 PREVATT ST",
            "address_2": "SUITE B3",
            "city": "EUSTIS",
            "state": "FL",
            "postal_code": "327266149",
            "telephone_number": "407-869-1450",
            "fax_number": "407-574-4625"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAUCH",
        "first_name": "MARSHA",
        "middle_name": "KIDDER",
        "name_prefix": "Dr.",
        "credential": "A.R.N.P., PHD.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-02-08",
        "last_updated": "2014-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "FL",
            "license": "ARNP518912",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "FL",
            "license": "ARNP518912",
            "primary": true
        },
        {
            "code": "364SP0808X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Psychiatric/Mental Health",
            "state": "FL",
            "license": "ARNP518912",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eustis, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2014; 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.