Individual provider Active NPI

Marina Judith-Rowe McIntyre, FNP

  • Family Nurse Practitioner
  • Ketchikan, AK
National Provider Identifier
1336570506
Registry record updated Mar 4, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
1445 Issued in AK
Practice address
3528 Tongass Ave
Ketchikan, AK 99901-5635
Phone
(907) 617-4481
NPI assigned
Dec 12, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Registered Nurse 163WE0003X 23560 AK
Family Nurse Practitioner 363LF0000X 1445 AK Primary

Addresses

Primary practice location

3528 Tongass Ave
Ketchikan, AK 99901-5635

Mailing address

PO Box 8093
Ketchikan, AK 99901-3093
Phone (907) 247-6724

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AK
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160713001560 AK Practitioner - Nurse Practitioner 7517182264 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Optimum Health and Wellness Physical Therapy IncGroup PAC ID 3870775604, 14 clinicians

Practice addresses (Care Compare)

4079 Tongass Ave
Suite 102
Ketchikan, AK 99901-5559
Phone (907) 225-7808

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
79.12 of 100Reported as group
Quality
81.91
Promoting interoperability
100
Improvement activities
40
Cost
40.93

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
1445AKMDEndodontist
23560AKMDEmergency Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Russell Degroote MD PC CurrentSince Sep 1, 2022 Accepting new patients
Optimum Health and Wellness Physical Therapy, Inc. CurrentSince Aug 26, 2025 Accepting new patients
Power of Wellness Health Services LLC PastSince Aug 1, 2019 Accepting new patients

Locations

4079 Tongass Ave
Ste 102
Ketchikan, AK 99901
Phone (907) 225-7808

7559 N Tongass Hwy
Ketchikan, AK 99901
Phone (907) 228-0185

Organizations & group practices 3

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": "1386806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614816000000",
    "number": "1336570506",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 8093",
            "city": "KETCHIKAN",
            "state": "AK",
            "postal_code": "999013093",
            "telephone_number": "907-247-6724"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3528 TONGASS AVE",
            "city": "KETCHIKAN",
            "state": "AK",
            "postal_code": "999015635",
            "telephone_number": "907-617-4481"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCINTYRE",
        "first_name": "MARINA",
        "middle_name": "JUDITH-ROWE",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-12-12",
        "last_updated": "2021-03-04",
        "certification_date": "2021-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WE0003X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Emergency",
            "state": "AK",
            "license": "23560",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AK",
            "license": "1445",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ketchikan, AK

Sources for this page

Verify at the official NPI Registry.