Kathleen Marmorine

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

R 138537-1 Issued in MN

Practice address

Highway 1
Box 497
Red Lake, MN 56671-0497

Phone

(218) 679-3912

Fax

(218) 679-0181

NPI assigned

Jul 3, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in TX

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

Specialty

Nurse Practitioner

Education

Other, 2001

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

PHS Indian Hospital 21 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Red Lake Hospital Hospital, Redlake, MN, CCN 240206
• Sanford Bemidji Medical Center Hospital, Bemidji, MN, CCN 240100

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

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.

• PHS Indian Hospital

  • General Acute Care Hospital
  • Red Lake, MN
  • NPI 1508809765

  TX

  Medicare reassignment Care Compare group NPD
• PHS Indian Hospital

  • Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy
  • Red Lake, MN
  • NPI 1063549822
  Care Compare group
• Pharmacy Dept. PHS Indian Hopsital

  • General Acute Care Hospital
  • Red Lake, MN
  • NPI 1972644318
  NPD (past)
• Ponemah Clinic

  • Health Service Clinic/Center
  • Red Lake, MN
  • NPI 1760680300
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Sanford Health of Northern Minnesota

  • Internal Medicine Physician
  • Bemidji, MN
  • NPI 1780628149

  Hospital

  Care Compare affiliation
• Sanford Health of Northern Minnesota

  • Rural Acute Care Hospital
  • Bemidji, MN
  • NPI 1801870191

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1151884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1194480000000",
    "number": "1356370993",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "HIGHWAY 1",
            "address_2": "BOX 497",
            "city": "RED LAKE",
            "state": "MN",
            "postal_code": "566710497"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "HIGHWAY 1",
            "address_2": "BOX 497",
            "city": "RED LAKE",
            "state": "MN",
            "postal_code": "566710497",
            "telephone_number": "218-679-3912",
            "fax_number": "218-679-0181"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARMORINE",
        "first_name": "KATHLEEN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-03",
        "last_updated": "2007-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MN",
            "license": "R 138537-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS OF MN",
            "identifier": "387K5MA",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rachel Koch, NURSE PRACTITIONER
• Anthony John Ladner, PHARMD.
• Nicole Larsen, RN
• Thomas Powell Luft, D.O.
• Mary E Mackey, PHARMD
• Tasha M Martell, CHW
• Vivianna Raylene Martin, PHARMD, MBA
• Michelle Ann Mathison, RN
• Casey Lee McDougall, PH.D., L.P.
• Mino-Miikanaang Bima'Adoo

• All providers in Red Lake, MN
• Family Nurse Practitioner in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2007; 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.

Verify at the official NPI Registry.