Active NPI
Mariann Richards Fark, MS, RNC, CNM
- Advanced Practice Midwife
- Fort Campbell, KY
National Provider Identifier
1184972549
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Advanced Practice Midwife
- License
- RN253468
- Practice address
- 650 Joel Dr
Fort Campbell, KY 42223-5318 - Phone
- (270) 956-0359
- NPI assigned
- Aug 16, 2012
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Advanced Practice Midwife | 367A00000X | RN253468 | MA | Primary |
Addresses
Primary practice location
650 Joel Dr
Fort Campbell, KY 42223-5318
Mailing address
650 Joel Dr
Fort Campbell, KY 42223-5318
Phone (270) 956-0359
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MA
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20241029001428 | MA | Practitioner - Certified Nurse Midwife (CNM) | 5799094157 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Certified Nurse Midwife, Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RN253468 | MA | MD | Advanced Practice Midwife |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Atrius Health, Inc. | Current | Accepting new patients | |
| Atrius Health, Inc. | Current | Accepting new patients | |
| Atrius Health, Inc. | Current | Accepting new patients |
Locations
147 Milk St
Fl 9
Boston, MA 02109
Phone (617) 559-8051
133 Brookline Ave
Boston, MA 02215
Phone (617) 421-1000
Interoperability endpoints
- mfarkcnm390389@direct.atrius.masshiway.net
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.
-
- Internal Medicine Physician
- Beverly, MA
- NPI 1114265634
-
- Radiation Oncology Physician
- Weymouth, MA
- NPI 1609991439
-
- Internal Medicine Physician
- Boston, MA
- NPI 1871639914
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1345075200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1544486400000",
"number": "1184972549",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "650 JOEL DR",
"city": "FORT CAMPBELL",
"state": "KY",
"postal_code": "422235318",
"telephone_number": "270-956-0359"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "650 JOEL DR",
"city": "FORT CAMPBELL",
"state": "KY",
"postal_code": "422235318",
"telephone_number": "270-956-0359"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FARK",
"first_name": "MARIANN",
"middle_name": "RICHARDS",
"credential": "MS, RNC, CNM",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-08-16",
"last_updated": "2018-12-11",
"status": "A"
},
"taxonomies": [
{
"code": "367A00000X",
"taxonomy_group": "",
"desc": "Advanced Practice Midwife",
"state": "MA",
"license": "RN253468",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Fort Campbell, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2018; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.