Individual provider Active NPI

Georgianna K. Marks, PHD, APRN, PC

  • Adult Psychiatric/Mental Health Clinical Nurse Specialist
  • Boston, MA
National Provider Identifier
1396854394
Registry record updated Jun 13, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Psychiatric/Mental Health Clinical Nurse SpecialistTaxonomy code 364SP0809X
License
124796 Issued in MA
Practice address
14 Cushing Ave
St Mary'S Church
Boston, MA 02125
Phone
(857) 230-0983
Fax
(866) 610-6501
NPI assigned
Aug 30, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 13, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Psychiatric/Mental Health Clinical Nurse Specialist 364SP0809X 124796 MA Primary

Addresses

Primary practice location

14 Cushing Ave
St Mary'S Church
Boston, MA 02125

Mailing address

14 Cushing Ave
St Mary'S Center
Boston, MA 02125
Phone (857) 230-0983

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
Certified Nurse Specialist, Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
124796MAMDAdult Psychiatric/Mental Health Clinical Nurse Specialist

NPI Registry JSON

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1465776000000",
    "number": "1396854394",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14 CUSHING AVE",
            "address_2": "ST MARY'S CENTER",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "02125",
            "telephone_number": "857-230-0983",
            "fax_number": "866-610-6501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14 CUSHING AVE",
            "address_2": "ST MARY'S CHURCH",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "02125",
            "telephone_number": "857-230-0983",
            "fax_number": "866-610-6501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARKS",
        "first_name": "GEORGIANNA",
        "middle_name": "K.",
        "name_prefix": "Ms.",
        "credential": "PHD, APRN, PC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-30",
        "last_updated": "2016-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364SP0809X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Psychiatric/Mental Health, Adult",
            "state": "MA",
            "license": "124796",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2016; 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.