Individual provider Active NPI

Marisa Diamond Jurisic, MSN, FNP-C

  • Family Nurse Practitioner
  • Mobile, AL
National Provider Identifier
1417546177
Registry record updated Nov 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
1-154589 Issued in AL
Practice address
6300 USA Health Blvd.
Mobile, AL 36608-0020
Phone
(251) 633-8880
Fax
(251) 633-2817
NPI assigned
Jan 15, 2021
Last updated
Nov 5, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 5, 2024

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 1-154589 AL Primary

Addresses

Primary practice location

6300 USA Health Blvd.
Mobile, AL 36608-0020

Mailing address

PO Box 21595
Belfast, ME 04915-4112
Phone (251) 318-2678

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
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
I20210413001732 AL Practitioner - Nurse Practitioner 1557779527 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of South Alabama College of Medicine, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University of South Alabama Health Care AuthorityGroup PAC ID 4082986088, 80 clinicians

Practice addresses (Care Compare)

6300 USA Health Blvd
Mobile, AL 36608-0020
Phone (251) 633-8880

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
96.27 of 100Reported as apm
Quality
82.53
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse, Master of Science - Nursing, Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Baldwin Emergency Physicians, P.C.. CurrentSince Oct 1, 2024 Accepting new patients
University of South Alabama Health Care Authority CurrentSince Nov 1, 2024 Accepting new patients
Imc-Emergency Physicians LLC CurrentSince May 3, 2021 Accepting new patients

Locations

1815 Hand Ave
Bay Minette, AL 36507
Phone (251) 279-1553

750 Morphy Ave
Fairhope, AL 36532
Phone (251) 928-2375

1725 Spring Hill Ave
Mobile, AL 36604
Phone (251) 435-1366

2423 Schillinger Rd S
Mobile, AL 36695
Phone (251) 660-5950

6300 USA Health Blvd
Mobile, AL 36608
Phone (251) 633-8880

6701 Airport Blvd
#A1
Mobile, AL 36608
Phone (251) 633-8880

Interoperability endpoints

  • Direct secure messaging: marisa.jurisic.1@16253.direct.athenahealth.com

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 4

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": "1610668800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730764800000",
    "number": "1417546177",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 21595",
            "city": "BELFAST",
            "state": "ME",
            "postal_code": "049154112",
            "telephone_number": "251-318-2678",
            "fax_number": "251-405-9500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6300 USA HEALTH BLVD.",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366080020",
            "telephone_number": "251-633-8880",
            "fax_number": "251-633-2817"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JURISIC",
        "first_name": "MARISA",
        "middle_name": "DIAMOND",
        "credential": "MSN, FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-01-15",
        "last_updated": "2024-11-05",
        "certification_date": "2024-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AL",
            "license": "1-154589",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mobile, AL

Sources for this page

Verify at the official NPI Registry.