Marcus Lawrence Couldridge
Individual provider Active NPI Family Medicine Physician · Shiprock, NM
NPI 1194468504 · NPPES record last updated Oct 7, 2025
Key facts
- NPI
- 1194468504
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- MD2025-0605 (NM)
- Practice address
- PO Box 160
Shiprock, NM 87420-0160 - Phone
- (505) 368-6001
- NPI assigned
- Apr 14, 2022
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
Hospital & facility affiliations 7
Medicare Care Compare profile
- Specialty
- Family Practice
- Education
- University of Washington School of Medicine, 2022
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- DHHS PHS Naihs Shiprock Hospital
Practice addresses (Care Compare)
Highway 491
Shiprock, NM 87420-0160
Phone 50536860016401
P O Box
160 Attn Business Office
Shiprock, NM 87420-0160
PO Box
Suite 160
Shiprock, NM 87420-0160
Hospital & facility affiliations
- Northern Navajo Medical Center
- San Juan Regional Medical Center Inc
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20260320002219 | TX | Practitioner - Family Practice | 0547640922 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD2025-0605 | NM | MD | Family Medicine Physician |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | MD2025-0605 | NM | Yes |
Addresses
Primary practice location
PO Box 160
Shiprock, NM 87420-0160
Mailing address
PO Box 160
Shiprock, NM 87420-0160
Other providers in Shiprock, NM
- John T Conner
- James Neal Cook
- Jenna P Cope
- Jessica Cornett Allen
- Katherine Costello
- Brianna Joy Cowan
- Deborah A Crabbe
- Debra Kay Crain
- Beverly Crawford
- Malaura Creager
All providers in Shiprock, NM · Family Medicine Physician in New Mexico
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 7, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.