Marissa Ann Kennell, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

C06622 Issued in MD

Practice address

6701 N Charles St
Baltimore, MD 21204-6808

Phone

(443) 849-2000

NPI assigned

Oct 13, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Marissa Ann Pierson Former name

Medicare fee-for-service enrollment

Enrolled in MD

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mpierson42570@gbmcdirect.org

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.

• Greater Baltimore Medical Center, Inc

  • Obstetrics & Gynecology Physician
  • Baltimore, MD
  • NPI 1891855763

  Physician Assistant

  Medicare reassignment NPD
• Greater Baltimore Medical Center, Inc.

  • Sleep Medicine (Internal Medicine) Physician
  • Baltimore, MD
  • NPI 1538029731
  NPD

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

{
    "created_epoch": "1507852800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1551312000000",
    "number": "1235640509",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "511 E GITTINGS ST",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212304332"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6701 N CHARLES ST",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212046808",
            "telephone_number": "443-849-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENNELL",
        "first_name": "MARISSA",
        "middle_name": "ANN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-10-13",
        "last_updated": "2019-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MD",
            "license": "C06622",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARISSA",
            "last_name": "PIERSON",
            "middle_name": "ANN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Nicole Cristtin Kennedy, LCSW C
• Patience Kennedy
• Sade Kennedy, PHD
• Sarah Kennedy, LMSW
• Kaitlin Kennefick, LMSW
• Nicholas Andrew Kenner
• Kenneth M. Greene, M.D. & Associates
• Kenneth Margolis MD Ambulatory Endoscopy Surgical Center
• Kenneth Margolis, M.D.,P.a.
• Kenneth Miller MD LLC

• Physician Assistant in Baltimore, MD
• Providers in Baltimore, MD by specialty
• Physician Assistant in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2019; 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.