Individual provider Active NPI

Richard Kevin Marlow, D.M.D.

  • Oral and Maxillofacial Surgery (Dentist)
  • Mankato, MN
National Provider Identifier
1306908702
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
D10685 Issued in MN
Practice address
1990 Premiere Dr
Mankato, MN 56001-5900
Phone
(507) 625-9330
Fax
(507) 625-1440
NPI assigned
Dec 14, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist) 1223S0112X D10685 MN Primary

Addresses

Primary practice location

1990 Premiere Dr
Mankato, MN 56001-5900

Mailing address

1990 Premiere Dr
Mankato, MN 56001-5900
Phone (507) 625-9330

Other identifiers 1

IdentifierTypeStateIssuer
06D39MAOtherMNBLUE CROSS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
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 1

Enrollment IDStateProvider typePAC IDDetails
I20050822000747 MN Practitioner - Maxillofacial Surgery 7315978103 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Maxillofacial Surgery
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Associates in Oral and Maxillofacial Surgery, P.a.Group PAC ID 7416988209, 3 clinicians

Practice addresses (Care Compare)

1990 Premier Dr
Mankato, MN 56001-5900
Phone (507) 625-9330

Hospital & facility affiliations

  • Mayo Clinic Health System - Mankato Hospital, Mankato, MN, CCN 240093

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Associates in Oral and Maxillofacial Surgery, P.a. Oral and Maxillofacial Surgery CurrentSince Jun 17, 1998 Accepting new patients

Locations

1025 Marsh St
Mankato, MN 56001
Phone (507) 345-2623

1990 Premier Dr
Mankato, MN 56001
Phone (507) 625-9330

Organizations & group practices 1

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1166054400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1306908702",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1990 PREMIERE DR",
            "city": "MANKATO",
            "state": "MN",
            "postal_code": "560015900",
            "telephone_number": "507-625-9330",
            "fax_number": "507-625-1440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1990 PREMIERE DR",
            "city": "MANKATO",
            "state": "MN",
            "postal_code": "560015900",
            "telephone_number": "507-625-9330",
            "fax_number": "507-625-1440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARLOW",
        "first_name": "RICHARD",
        "middle_name": "KEVIN",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-14",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "MN",
            "license": "D10685",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "06D39MA",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mankato, MN

Sources for this page

Verify at the official NPI Registry.