Individual provider Active NPI

Laura Marx, RN

  • Family Nurse Practitioner
  • Missoula, MT
National Provider Identifier
1366548604
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN22313 Issued in MT
Practice address
610 N California St
Missoula, MT 59802-3950
Phone
(406) 721-1646
Fax
(406) 543-9890
NPI assigned
Sep 15, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 RN22313 MT Primary

Addresses

Primary practice location

610 N California St
Missoula, MT 59802-3950

Mailing address

610 N California St
Missoula, MT 59802-3950
Phone (406) 721-1646

Other identifiers 1

IdentifierTypeStateIssuer
0430209MedicaidMT

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MT
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
I20100319000455 MT Practitioner - Nurse Practitioner 6507991304 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1975
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2829 Great Northern Loop
Suite B108
Missoula, MT 59808-1752
Phone (406) 546-3043

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN22313MTMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Jiivana Integrative Health PLLC CurrentSince Nov 17, 2010 Accepting new patients

Locations

2829 Great Northern Loop
Ste B108
Missoula, MT 59808
Phone (406) 546-3043

Organizations & group practices 1

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": "1158278400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1366548604",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "610 N CALIFORNIA ST",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598023950",
            "telephone_number": "406-721-1646",
            "fax_number": "406-543-9890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "610 N CALIFORNIA ST",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598023950",
            "telephone_number": "406-721-1646",
            "fax_number": "406-543-9890"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARX",
        "first_name": "LAURA",
        "name_prefix": "Mrs.",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-15",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MT",
            "license": "RN22313",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0430209",
            "state": "MT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Missoula, MT

Sources for this page

Verify at the official NPI Registry.