Individual provider Active NPI

Marian Harrison, CNP

  • Family Nurse Practitioner
  • Cincinnati, OH
National Provider Identifier
1336728195
Registry record updated Apr 7, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
0028625 Issued in OH
Practice address
4308 Copperfield LN
Cincinnati, OH 45238-6206
Phone
(513) 460-0779
NPI assigned
Apr 7, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 7, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 0028625 OH Primary

Addresses

Primary practice location

4308 Copperfield LN
Cincinnati, OH 45238-6206

Mailing address

4308 Copperfield LN
Cincinnati, OH 45238-6206

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH, KY, FL, CA4 enrollments
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 4

Enrollment IDStateProvider typePAC IDDetails
I20220415001111 OH Practitioner - Nurse Practitioner 5698161867 Reassigns benefits to 3 organizations
I20230817003013 KY Practitioner - Nurse Practitioner 5698161867 Reassigns benefits to 1 organization
I20241009001555 FL Practitioner - Nurse Practitioner 5698161867 Reassigns benefits to 1 organization
I20241211000704 CA Practitioner - Nurse Practitioner 5698161867 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0028625OHMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Universal Care CurrentSince Nov 14, 2024 Accepting new patients
Central Health Plan of California, Inc. CurrentSince Nov 14, 2024 Accepting new patients
Molina Healthcare of California CurrentSince Nov 14, 2024 Accepting new patients
Molina Care Connections, LLC. CurrentSince Sep 25, 2023 Accepting new patients

Locations

200 Oceangate
Ste 100
Long Beach, CA 90802
Phone (562) 435-3666

8300 NW 33rd St
Ste 400
Doral, FL 33122
Phone (904) 229-7396

5100 Commerce Crossings Dr
Louisville, KY 40229
Phone (502) 305-6267

3000 Corporate Exchange Dr
Columbus, OH 43231
Phone (614) 942-3042

Interoperability endpoints

  • Direct secure messaging: mharrison15123@direct-prd.molinahealthcare.com

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1617753600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617753600000",
    "number": "1336728195",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4308 COPPERFIELD LN",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452386206"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4308 COPPERFIELD LN",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452386206",
            "telephone_number": "513-460-0779"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRISON",
        "first_name": "MARIAN",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-04-07",
        "last_updated": "2021-04-07",
        "certification_date": "2021-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "0028625",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cincinnati, OH

Sources for this page

Verify at the official NPI Registry.