Individual provider Active NPI

Marni Saige Wendeborn, FNP

  • Family Nurse Practitioner
  • Lubbock, TX
National Provider Identifier
1205398971
Registry record updated Jun 4, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
813477 Issued in TX
Practice address
4003 113TH St
Lubbock, TX 79423-1979
Phone
(523) 246-6385
Fax
(432) 758-4761
NPI assigned
Apr 2, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 4, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 813477 TX Primary

Addresses

Primary practice location

4003 113TH St
Lubbock, TX 79423-1979

Mailing address

3410 98TH St Ste 4-143
Lubbock, TX 79423-3847
Phone (352) 246-6385

Other identifiers 1

IdentifierTypeStateIssuer
023219102MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190628002179 TX Practitioner - Nurse Practitioner 6204160963 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Tuamokumo Consulting PLLCGroup PAC ID 1759623465, 6 clinicians

Practice addresses (Care Compare)

4003 113TH St
Lubbock, TX 79423-1979
Phone (806) 730-3458

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
813477TXMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Tuamokumo Consulting PLLC CurrentSince Jun 1, 2019 Accepting new patients

Locations

10303 Indiana Ave
Ste 400
Lubbock, TX 79423

3410 98th St
Ste 4143
Lubbock, TX 79423

Organizations & group practices 1

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.

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1554163200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1559606400000",
    "number": "1205398971",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3410 98TH ST STE 4-143",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794233847",
            "telephone_number": "352-246-6385"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4003 113TH ST",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794231979",
            "telephone_number": "523-246-6385",
            "fax_number": "432-758-4761"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WENDEBORN",
        "first_name": "MARNI",
        "middle_name": "SAIGE",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-02",
        "last_updated": "2019-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "813477",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "023219102",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lubbock, TX

Sources for this page

Verify at the official NPI Registry.