Kristie K Marbut, ARNP

Primary specialty

Neonatal Nurse PractitionerTaxonomy code 363LN0000X

License

AP30004331 Issued in WA

Practice address

4113 Bridgeport Way W
Suite F
University Place, WA 98466-4325

Phone

(253) 565-7686

Fax

(253) 566-0210

NPI assigned

Aug 26, 2005

Last updated

Sep 17, 2014By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• St Lukes Clinic-Treasure Valley LLC

  • Family Medicine Physician
  • Boise, ID
  • NPI 1326336058

  Neonatal-Perinatal Medicine

  NPD

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

{
    "created_epoch": "1125014400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1410912000000",
    "number": "1225021934",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3698 REDMAPLE RD",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841061521",
            "telephone_number": "801-906-0513",
            "fax_number": "801-906-0516"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4113 BRIDGEPORT WAY W",
            "address_2": "SUITE F",
            "city": "UNIVERSITY PLACE",
            "state": "WA",
            "postal_code": "984664325",
            "telephone_number": "253-565-7686",
            "fax_number": "253-566-0210"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARBUT",
        "first_name": "KRISTIE",
        "middle_name": "K",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-26",
        "last_updated": "2014-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LN0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Neonatal",
            "state": "WA",
            "license": "AP30004331",
            "primary": true
        },
        {
            "code": "363LN0005X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Neonatal, Critical Care",
            "state": "UT",
            "license": "50963944405",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "WA",
            "license": "AP30004331",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marla Mallatt, RN
• Mallory Mackie PLLC
• Mary Salve Manajero, LPN
• Cortney Manning-Tripp
• Erin Elaine Manning
• Jenna Marie Mariotti, LMP
• Mark D Nellermoe Professional Service Corporation
• Laura Marshall, DO
• Michael Ernest Martin, DDS
• Rhonda Paige Martin, MPT

• Neonatal Nurse Practitioner in University Place, WA
• Providers in University Place, WA by specialty
• Neonatal Nurse Practitioner in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2014; 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.

Verify at the official NPI Registry.