Individual provider Active NPI

Marrisa Dean, CNP

  • Family Nurse Practitioner
  • Lovington, NM
National Provider Identifier
1407445380
Registry record updated Jan 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
61719 Issued in NM
Practice address
1600 N Main Ave
Lovington, NM 88260-2813
Phone
(575) 396-6611
NPI assigned
Jan 14, 2021
Last updated
Jan 14, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 14, 2021

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 61719 NM Primary

Addresses

Primary practice location

1600 N Main Ave
Lovington, NM 88260-2813

Mailing address

1600 N Main Ave
Lovington, NM 88260-2813
Phone (575) 396-6611

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM
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
I20210218002479 NM Practitioner - Nurse Practitioner 8123269453 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Nor-Lea Hospital DistrictGroup PAC ID 2466364534, 58 clinicians

Practice addresses (Care Compare)

1600 N Main
Lovington, NM 88260-2813

1600 N Main Ave
Lovington, NM 88260-2813
Phone 57539666115303

515 E Main St
Hobbs, NM 88240-8119
Phone (575) 397-0560

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
61719NMMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Nor-Lea Hospital District CurrentSince Feb 8, 2021 Accepting new patients
Nor-Lea Hospital District CurrentSince Feb 8, 2021 Accepting new patients
Nor-Lea Hospital District Past Accepting new patients

Locations

1923 N Dal Paso St
Ste A
Hobbs, NM 88240
Phone (575) 433-3000

1923 N Dal Paso St
Ste B
Hobbs, NM 88240
Phone (575) 397-2463

515 E Main St
Hobbs, NM 88240
Phone (575) 397-0560

800 N Jefferson St
Bldg Shch
Hobbs, NM 88240
Phone (575) 433-3030

1600 N Main Ave
Lovington, NM 88260
Phone (575) 396-6611

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1610582400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610582400000",
    "number": "1407445380",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 N MAIN AVE",
            "city": "LOVINGTON",
            "state": "NM",
            "postal_code": "882602813",
            "telephone_number": "575-396-6611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 N MAIN AVE",
            "city": "LOVINGTON",
            "state": "NM",
            "postal_code": "882602813",
            "telephone_number": "575-396-6611"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEAN",
        "first_name": "MARRISA",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-01-14",
        "last_updated": "2021-01-14",
        "certification_date": "2021-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NM",
            "license": "61719",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lovington, NM

Sources for this page

Verify at the official NPI Registry.