Individual provider Active NPI

Loretta M. Marion, DO

  • Pediatrics Physician
  • Providence, RI
National Provider Identifier
1285690313
Registry record updated Dec 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
DO01075 Issued in RI
Practice address
355 Prairie Ave
Providence, RI 02905-1928
Phone
(401) 444-0570
Fax
(401) 444-0427
NPI assigned
Apr 26, 2006
Last updated
Dec 14, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 14, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X OS007739L PA
Pediatrics Physician 208000000X DO37583 SC
Pediatrics Physician 208000000X DO01075 RI Primary

Addresses

Primary practice location

355 Prairie Ave
Providence, RI 02905-1928

Mailing address

375 Allens Ave
Providence, RI 02905-5010
Phone (401) 780-2511

Other practice location 1

101 Dudley St
Providence, RI 02905-2401
Phone (401) 274-1122

Other identifiers 1

IdentifierTypeStateIssuer
001592004MedicaidPA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address lmarion59545@HCNetwork.direct-ci.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, RI2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20040414000022 PA Practitioner - Pediatric Medicine 1254325046 Reassigns benefits to 1 organization
I20210622001458 RI Practitioner - Pediatric Medicine 1254325046 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
DO01075RIMDPediatrics Physician
DO37583SCMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Affinity Physicians LLC CurrentSince Oct 16, 2022 Accepting new patients
Affinity Physicians LLC. Pediatrics CurrentSince Oct 16, 2022 Accepting new patients
Geisinger Clinic Current Accepting new patients
Geisinger Clinic Pediatrics CurrentSince Jan 4, 1997 Accepting new patients
Geisinger Clinic CurrentSince Jan 4, 1997 Accepting new patients

Locations

100 N Academy Ave
Danville, PA 17822

101 Dudley St
Providence, RI 02905
Phone (401) 453-7950

455 Toll Gate Rd
Warwick, RI 02886
Phone (401) 737-7000

Interoperability endpoints

  • Direct secure messaging: drmarion@palmettopeds.opdirect.net
  • Direct secure messaging: lmarion59545@hcnetwork.direct-ci.com

Organizations & group practices 5

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": "1146009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702512000000",
    "number": "1285690313",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "375 ALLENS AVE",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029055010",
            "telephone_number": "401-780-2511",
            "fax_number": "401-780-2565"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "355 PRAIRIE AVE",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029051928",
            "telephone_number": "401-444-0570",
            "fax_number": "401-444-0427"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "101 Dudley St",
            "address_purpose": "LOCATION",
            "city": "Providence",
            "state": "RI",
            "postal_code": "029052401",
            "country_code": "US",
            "telephone_number": "401-274-1122",
            "fax_number": "401-453-7571",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MARION",
        "first_name": "LORETTA",
        "middle_name": "M.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-26",
        "last_updated": "2023-12-14",
        "certification_date": "2023-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "PA",
            "license": "OS007739L",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "SC",
            "license": "DO37583",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "RI",
            "license": "DO01075",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001592004",
            "state": "PA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lmarion59545@HCNetwork.direct-ci.com",
            "affiliation": "N",
            "address_1": "355 Prairie Ave",
            "city": "Providence",
            "state": "RI",
            "country_code": "US",
            "postal_code": "029051928",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Providence, RI

Sources for this page

Verify at the official NPI Registry.