Individual provider Active NPI

Austin Tyler Marriner, R.N.

  • Registered Nurse
  • Andover, MA
National Provider Identifier
1275912099
Registry record updated May 26, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
R056582 Issued in ME
Practice address
200 Brickstone SQ
Andover, MA 01810-1437
Phone
(978) 474-7500
NPI assigned
May 26, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 26, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X R056582 ME Primary

Addresses

Primary practice location

200 Brickstone SQ
Andover, MA 01810-1437

Mailing address

PO Box 156
Lincolnville Center, ME 04850-0156
Phone (207) 975-1211

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

LicenseStateTypeSpecialty
R056582MEMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1432598400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1432598400000",
    "number": "1275912099",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 156",
            "city": "LINCOLNVILLE CENTER",
            "state": "ME",
            "postal_code": "048500156",
            "telephone_number": "207-975-1211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 BRICKSTONE SQ",
            "city": "ANDOVER",
            "state": "MA",
            "postal_code": "018101437",
            "telephone_number": "978-474-7500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARRINER",
        "first_name": "AUSTIN",
        "middle_name": "TYLER",
        "name_prefix": "Mr.",
        "credential": "R.N.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-05-26",
        "last_updated": "2015-05-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "ME",
            "license": "R056582",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Andover, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.