Individual provider Active NPI

Marilyn B Innocent, M.D

  • Family Medicine Physician
  • Lake Worth, FL
National Provider Identifier
1346340254
Registry record updated Aug 26, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
ME93404 Issued in FL
Practice address
220 S Dixie Hwy
Suite 4
Lake Worth, FL 33460-4153
Phone
(561) 429-5086
Fax
(561) 290-4144
NPI assigned
Sep 22, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 26, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X ME93404 FL Primary

Addresses

Primary practice location

220 S Dixie Hwy
Suite 4
Lake Worth, FL 33460-4153

Mailing address

PO Box 221313
West Palm Beach, FL 33422-1313
Phone (561) 429-5086

Other identifiers 1

IdentifierTypeStateIssuer
007403900MedicaidFL

Other names 1

  • Dr. Marilyn Belizaire Innocent Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Lincare Pulmonary Rehab Services of Florida, P.L. Past Accepting new patients
Wilmar Medical Corp Past Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1158883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1377475200000",
    "number": "1346340254",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 221313",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "334221313",
            "telephone_number": "561-429-5086",
            "fax_number": "561-290-4144"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "220 S DIXIE HWY",
            "address_2": "SUITE 4",
            "city": "LAKE WORTH",
            "state": "FL",
            "postal_code": "334604153",
            "telephone_number": "561-429-5086",
            "fax_number": "561-290-4144"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "INNOCENT",
        "first_name": "MARILYN",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "credential": "M.D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-22",
        "last_updated": "2013-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME93404",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "007403900",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARILYN",
            "last_name": "INNOCENT",
            "middle_name": "BELIZAIRE",
            "prefix": "DR.",
            "credential": "M.D",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Lake Worth, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.