Individual provider Active NPI

Marla Crist Schenck, A.R.N.P.

  • Family Nurse Practitioner
  • Tampa, FL
National Provider Identifier
1215932835
Registry record updated Mar 12, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
ARNP3178552 Issued in FL
Practice address
4915 Ehrlich Rd
Tampa, FL 33624-2038
Phone
(813) 960-2400
Fax
(813) 960-2410
NPI assigned
Jun 20, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 12, 2014

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 ARNP3178552 FL Primary

Addresses

Primary practice location

4915 Ehrlich Rd
Tampa, FL 33624-2038

Mailing address

4200 N Armenia Ave
Ste 1
Tampa, FL 33607-6438
Phone (813) 877-4811

Other identifiers 5

IdentifierTypeStateIssuer
305983900MedicaidFL
1411796OtherFLCOVENTRY
9599505OtherFLAETNA
285850OtherFLAVMED
P01161607OtherRAILROAD MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20040618000417 FL Practitioner - Nurse Practitioner 7416932116 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Christopher G. Nelson, M.D., P.a. Past Accepting new patients
Dermatology Group of Florida, P.a. Past Accepting new patients
Robert a. Norman, D.O., P.a. Past Accepting new patients

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1119225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1394582400000",
    "number": "1215932835",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4200 N ARMENIA AVE",
            "address_2": "STE 1",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336076438",
            "telephone_number": "813-877-4811",
            "fax_number": "813-872-8978"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4915 EHRLICH RD",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336242038",
            "telephone_number": "813-960-2400",
            "fax_number": "813-960-2410"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHENCK",
        "first_name": "MARLA",
        "middle_name": "CRIST",
        "credential": "A.R.N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-06-20",
        "last_updated": "2014-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "ARNP3178552",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "305983900",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COVENTRY",
            "identifier": "1411796",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "9599505",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AVMED",
            "identifier": "285850",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P01161607",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

Verify at the official NPI Registry.