Active NPI
Wendy Nicole Marino, MSN, NP-BC, CORLN
- Otolaryngology Physician
- Jackson, MS
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Otolaryngology Physician
- License
- MARI-5T0VNQ
- Practice address
- 764 Lakeland Dr
Jackson, MS 39216-4651 - Phone
- (601) 984-5516
- NPI assigned
- May 31, 2017
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Otolaryngology Physician | 207Y00000X | MARI-5T0VNQ | MS | Primary |
Addresses
Primary practice location
764 Lakeland Dr
Jackson, MS 39216-4651
Mailing address
764 Lakeland Drive
4TH Floor
Jackson, MS 39073
Phone (601) 984-5160
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MS
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2017
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
2500 N State St
Jackson, MS 39216-4500
Phone (601) 898-4404
Hospital & facility affiliations
Merit-based Incentive Payment System (MIPS)
- Final score
- 83.94 of 100
- Quality
- 67.75
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 71.17
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Master of Science - Nursing, Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MARI-5T0VNQ | MS | MD | Otolaryngology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| State of Mississippi - University of Mississippi Medical Center | Current | Accepting new patients | |
| State of Mississippi - University of Mississippi Medical Center | Current | Accepting new patients |
Locations
764 Lakeland Dr
Fl 4
Jackson, MS 39216
Phone (601) 815-6700
764 Lakeland Dr
Jackson, MS 39216
Phone (601) 982-0611
2500 N State St
Jackson, MS 39216
Phone (601) 815-4775
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 and National Provider Directory roles.
-
- General Acute Care Hospital
- Jackson, MS
- NPI 1154317527
-
- Prosthetic/Orthotic Supplier
- Jackson, MS
- NPI 1235019530
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Jackson, MS
- NPI 1154317527
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1496188800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1529107200000",
"number": "1336677624",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "764 LAKELAND DRIVE",
"address_2": "4TH FLOOR",
"city": "JACKSON",
"state": "MS",
"postal_code": "39073",
"telephone_number": "601-984-5160"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "764 LAKELAND DR",
"city": "JACKSON",
"state": "MS",
"postal_code": "392164651",
"telephone_number": "601-984-5516"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARINO",
"first_name": "WENDY",
"middle_name": "NICOLE",
"credential": "MSN, NP-BC, CORLN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-05-31",
"last_updated": "2018-06-16",
"status": "A"
},
"taxonomies": [
{
"code": "207Y00000X",
"taxonomy_group": "",
"desc": "Otolaryngology",
"state": "MS",
"license": "MARI-5T0VNQ",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Jackson, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2018; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.