NPIMap

Organization Active NPI

Elizabeth a Sharp-Marsden FNP PLLC

  • Family Nurse Practitioner
  • Idaho Falls, ID
National Provider Identifier
1326532201
Registry record updated Mar 6, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
53940 Issued in ID
Legal business name
ELIZABETH A SHARP-MARSDEN FNP PLLC
Practice address
2275 Channing Way
Idaho Falls, ID 83404-8012
Phone
(208) 313-7900
NPI assigned
Jun 14, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 6, 2019

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

Authorized official

Name
Elizabeth A Sharp-Marsden, FNPNPI 1740771898
Title
Owner
Phone
(208) 313-7900

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LF0000X 53940 ID Primary

Addresses

Primary practice location

2275 Channing Way
Idaho Falls, ID 83404-8012

Mailing address

PO Box 2426
Idaho Falls, ID 83403-2426
Phone (208) 535-9009

Other identifiers 1

IdentifierTypeStateIssuer
1326532201MedicaidID

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190516001930 ID Part B Supplier - Clinic/Group Practice 2163764663 Receives reassigned benefits from 5 practitioners
Practice locations: Idaho Falls, ID

National Provider Directory

National Provider Directory

Locations

2275 Channing Way
Idaho Falls, ID 83404
Phone (208) 313-7900

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1528934400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1551830400000",
    "number": "1326532201",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2426",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834032426",
            "telephone_number": "208-535-9009",
            "fax_number": "208-535-9020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2275 CHANNING WAY",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834048012",
            "telephone_number": "208-313-7900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELIZABETH A SHARP-MARSDEN FNP PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-06-14",
        "last_updated": "2019-03-06",
        "status": "A",
        "authorized_official_last_name": "SHARP-MARSDEN",
        "authorized_official_first_name": "ELIZABETH",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "208-313-7900",
        "authorized_official_credential": "FNP"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "ID",
            "license": "53940",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1326532201",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Idaho Falls, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.