Individual provider Active NPI

Laura L Mark, NP

  • Nurse Practitioner
  • Marshfield, MA
National Provider Identifier
1306381751
Registry record updated Nov 6, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
RN2266036 Issued in MA
Practice address
439 Plain St
Marshfield, MA 02050-2730
Phone
(781) 422-9009
NPI assigned
Dec 21, 2016
Last updated
Nov 6, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 6, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X RN2266036 MA Primary

Addresses

Primary practice location

439 Plain St
Marshfield, MA 02050-2730

Mailing address

439 Plain St
Marshfield, MA 02050-2730
Phone (781) 422-9009

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address rejuv@rejuvma.com Direct

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)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN2266036MAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Rejuv Medical Aesthetics Nurse Practitioner CurrentSince Nov 15, 2020 Accepting new patients
South Shore Nephrology, P.C. PastSince Feb 1, 2017 Accepting new patients

Locations

439 Plain St
Marshfield, MA 02050
Phone (781) 422-9009

Organizations & group practices 2

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": "1482278400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604620800000",
    "number": "1306381751",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "439 PLAIN ST",
            "city": "MARSHFIELD",
            "state": "MA",
            "postal_code": "020502730",
            "telephone_number": "781-422-9009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "439 PLAIN ST",
            "city": "MARSHFIELD",
            "state": "MA",
            "postal_code": "020502730",
            "telephone_number": "781-422-9009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARK",
        "first_name": "LAURA",
        "middle_name": "L",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-12-21",
        "last_updated": "2020-11-06",
        "certification_date": "2020-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MA",
            "license": "RN2266036",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rejuv@rejuvma.com",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Email",
            "address_1": "439 Plain St",
            "city": "Marshfield",
            "state": "MA",
            "country_code": "US",
            "postal_code": "020502730",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Marshfield, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2020; 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.