Active NPI
Marshall James Ayer, R.N.
- Nutrition Support Registered Nurse
- Bluford, IL
National Provider Identifier
1245769322
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nutrition Support Registered Nurse
- License
- 041.300163
- Practice address
- 156 Il Highway 15
Bluford, IL 62814-3630 - Phone
- (618) 734-6062
- NPI assigned
- Jun 12, 2017
- Last updated
- Jun 12, 2017
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nutrition Support Registered Nurse | 163WN1003X | 041.300163 | IL | Primary |
Addresses
Primary practice location
156 Il Highway 15
Bluford, IL 62814-3630
Mailing address
156 Il Highway 15
Bluford, IL 62814-3630
Phone (618) 734-6062
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 041.300163 | IL | MD | Nutrition Support Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1497225600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1497225600000",
"number": "1245769322",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "156 IL HIGHWAY 15",
"city": "BLUFORD",
"state": "IL",
"postal_code": "628143630",
"telephone_number": "618-734-6062"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "156 IL HIGHWAY 15",
"city": "BLUFORD",
"state": "IL",
"postal_code": "628143630",
"telephone_number": "618-734-6062"
}
],
"practiceLocations": [],
"basic": {
"last_name": "AYER",
"first_name": "MARSHALL",
"middle_name": "JAMES",
"name_prefix": "Mr.",
"credential": "R.N.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2017-06-12",
"last_updated": "2017-06-12",
"status": "A"
},
"taxonomies": [
{
"code": "163WN1003X",
"taxonomy_group": "",
"desc": "Registered Nurse, Nutrition Support",
"state": "IL",
"license": "041.300163",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bluford, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.