Carolyn S Marley, ANP

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

2002007745 Issued in MO

Practice address

1235 E Cherokee St
Springfield, MO 65804-2203

Phone

(417) 820-2000

NPI assigned

Aug 14, 2006

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 identifiers 1

Other names 1

• Carolyn S Clinkenbeard Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

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.

• Lincoln County Hospital

  • Critical Access Hospital
  • Lincoln, KS
  • NPI 1942265327
  NPD (past)
• Main Line Emergency Med Associates LLC

  • Emergency Medicine Physician
  • Paoli, PA
  • NPI 1316919368
  NPD (past)

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

{
    "created_epoch": "1155513600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1427760000000",
    "number": "1306859301",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 504274",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631504274",
            "telephone_number": "417-829-4620",
            "fax_number": "417-829-4316"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1235 E CHEROKEE ST",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658042203",
            "telephone_number": "417-820-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARLEY",
        "first_name": "CAROLYN",
        "middle_name": "S",
        "credential": "ANP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-14",
        "last_updated": "2015-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MO",
            "license": "2002007745",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "427268107",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CAROLYN",
            "last_name": "CLINKENBEARD",
            "middle_name": "S",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Jessica Marez, MSW, LCSW
• Kalyn Marino, DMD
• Katherine Diana Markley, P.T.
• Linda L Markovich, MA, LPC
• James A Markusic, PH.D.
• Martha L Marlin, L.P.C.
• Kerry A. Marsh, M.A., PLPC
• Kevin Kip Marsh, FNP
• Melanie Marsh, NP
• Derrick Marshall, DDS

• Adult Health Nurse Practitioner in Springfield, MO
• Providers in Springfield, MO by specialty
• Adult Health Nurse Practitioner in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2015; 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.