Individual provider Active NPI

Anjali Marble, D.O.

  • Family Medicine Physician
  • Raleigh, NC
National Provider Identifier
1164884698
Registry record updated May 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
2020-00339 Issued in NC
Practice address
4551 New Bern Ave Ste 100
Raleigh, NC 27610-2797
Phone
(984) 215-4950
Fax
(984) 215-4955
NPI assigned
Mar 23, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 11, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Family Medicine Physician 207Q00000X 2020-00339 NC Primary

Addresses

Primary practice location

4551 New Bern Ave Ste 100
Raleigh, NC 27610-2797

Mailing address

2000 Perimeter Park Dr Ste 200
Morrisville, NC 27560-8442

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address amarble635439@direct.UNC.nchie.net Direct

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200515001206 NC Practitioner - Family Practice 9335493956 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
2020-00339NCMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Unc Physicians Network LLC Family Medicine Current Accepting new patients
Unc Physicians Network LLC Family Medicine CurrentSince Apr 15, 2020 Accepting new patients

Locations

940 Martin Luther King Jr Blvd
Chapel Hill, NC 27514
Phone (919) 942-5123

2000 Perimeter Park Dr
Ste 200
Morrisville, NC 27560
Phone (800) 594-8624

4551 New Bern Ave
Ste 100
Raleigh, NC 27610
Phone (984) 215-4950

Interoperability endpoints

  • Direct secure messaging: amarble635439@direct.unc.nchie.net

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": "1458691200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620691200000",
    "number": "1164884698",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2000 PERIMETER PARK DR STE 200",
            "city": "MORRISVILLE",
            "state": "NC",
            "postal_code": "275608442"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4551 NEW BERN AVE STE 100",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276102797",
            "telephone_number": "984-215-4950",
            "fax_number": "984-215-4955"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARBLE",
        "first_name": "ANJALI",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-03-23",
        "last_updated": "2021-05-11",
        "certification_date": "2021-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "2020-00339",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "amarble635439@direct.UNC.nchie.net",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/CCD/TXT",
            "address_1": "4551 New Bern Ave Ste 100",
            "city": "Raleigh",
            "state": "NC",
            "country_code": "US",
            "postal_code": "276102797",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Raleigh, NC

Sources for this page

Verify at the official NPI Registry.