Individual provider Active NPI

Marilyn Sue Ward, M.D.

  • Psychiatry Physician
  • Clearwater, FL
National Provider Identifier
1417984816
Registry record updated Sep 5, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
ME89531 Issued in FL
Practice address
626 Lakeview Rd
Suite B
Clearwater, FL 33756-3359
Phone
(727) 449-8331
Fax
(727) 446-1810
NPI assigned
Jun 28, 2006
Last updated
Sep 5, 2014By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 5, 2014

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Forensic Psychiatry Physician 2084F0202X 126223 NY
Psychiatry Physician 2084P0800X 126223 NY
Psychiatry Physician 2084P0800X ME89531 FL Primary
Geriatric Psychiatry Physician 2084P0805X 126223 NY

Addresses

Primary practice location

626 Lakeview Rd
Suite B
Clearwater, FL 33756-3359

Mailing address

626 Lakeview Rd
Suite B
Clearwater, FL 33756-3359
Phone (727) 449-8331

Other identifiers 1

IdentifierTypeStateIssuer
005623400MedicaidFL

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
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
126223NYMDGeriatric Psychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mental Health Resource Center Inc PastSince Jul 4, 2021 Accepting new patients
Professional Practice Group, Dept. of Psych Psychiatry PastSince Jul 1, 1999 Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1151452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1409875200000",
    "number": "1417984816",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "626 LAKEVIEW RD",
            "address_2": "SUITE B",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337563359",
            "telephone_number": "727-449-8331",
            "fax_number": "727-446-1810"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "626 LAKEVIEW RD",
            "address_2": "SUITE B",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337563359",
            "telephone_number": "727-449-8331",
            "fax_number": "727-446-1810"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WARD",
        "first_name": "MARILYN",
        "middle_name": "SUE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-06-28",
        "last_updated": "2014-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084F0202X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Forensic Psychiatry",
            "state": "NY",
            "license": "126223",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NY",
            "license": "126223",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "FL",
            "license": "ME89531",
            "primary": true
        },
        {
            "code": "2084P0805X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Geriatric Psychiatry",
            "state": "NY",
            "license": "126223",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "005623400",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Clearwater, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2014; 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.