Individual provider Active NPI

Misty Dawn Marsh

  • Adult Health Nurse Practitioner
  • Galax, VA
National Provider Identifier
1417767013
Registry record updated Jan 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
0024192237 Issued in VA
Practice address
101 Doctors Park
Galax, VA 24333-2277
Phone
(276) 601-2540
NPI assigned
Jan 7, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 0024192237 VA Primary

Addresses

Primary practice location

101 Doctors Park
Galax, VA 24333-2277

Mailing address

101 Doctors Park
Galax, VA 24333-2277

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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
I20250320002595 VA Practitioner - Nurse Practitioner 9032468756 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Hope Medical ClinicGroup PAC ID 5496139735, 3 clinicians
Universal Health CorporationGroup PAC ID 5597912626, 120 clinicians

Practice addresses (Care Compare)

101 Doctors Park
Galax, VA 24333-2277
Phone (276) 233-5696

1945 Roanoke Blvd
Salem, VA 24153-6408
Phone (540) 345-3894

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Hope Medical Clinic CurrentSince Jan 10, 2025 Accepting new patients

Locations

101 Doctors Park
Galax, VA 24333
Phone (276) 233-5696

Organizations & group practices 2

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.

Hospital & facility affiliations 2

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": "1736208000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737590400000",
    "number": "1417767013",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 DOCTORS PARK",
            "city": "GALAX",
            "state": "VA",
            "postal_code": "243332277"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 DOCTORS PARK",
            "city": "GALAX",
            "state": "VA",
            "postal_code": "243332277",
            "telephone_number": "276-601-2540"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARSH",
        "first_name": "MISTY",
        "middle_name": "DAWN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-01-07",
        "last_updated": "2025-01-23",
        "certification_date": "2025-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "VA",
            "license": "0024192237",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Galax, VA

Sources for this page

Verify at the official NPI Registry.