Individual provider Active NPI

Marinda Gaye Botts, LPN

  • Licensed Practical Nurse
  • Robbins, TN
National Provider Identifier
1376385229
Registry record updated Jun 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
50901 Issued in TN
Practice address
575 W Robbins Rd
Robbins, TN 37852-3524
Phone
(423) 215-0565
NPI assigned
Jun 11, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 11, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 50901 TN Primary

Addresses

Primary practice location

575 W Robbins Rd
Robbins, TN 37852-3524

Mailing address

575 W Robbins Rd
Robbins, TN 37852-3524
Phone (423) 215-0565

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
50901TNMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1718064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718064000000",
    "number": "1376385229",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "575 W ROBBINS RD",
            "city": "ROBBINS",
            "state": "TN",
            "postal_code": "378523524",
            "telephone_number": "423-215-0565"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "575 W ROBBINS RD",
            "city": "ROBBINS",
            "state": "TN",
            "postal_code": "378523524",
            "telephone_number": "423-215-0565"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOTTS",
        "first_name": "MARINDA",
        "middle_name": "GAYE",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-06-11",
        "last_updated": "2024-06-11",
        "certification_date": "2024-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "TN",
            "license": "50901",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Robbins, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2024; 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.