Marissa Lee Fahrbach

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

0994226 Issued in CO

Practice address

1755 48TH St Ste 100
Boulder, CO 80301-2712

Phone

(303) 604-5000

Fax

(720) 890-0364

NPI assigned

Jun 19, 2015

Last updated

Mar 5, 2020By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other names 1

• Marisssa Lee Benson Former name

Medicare fee-for-service enrollment

Enrolled in CO

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse

State licenses

Practice roles

Locations

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.

• Boulder Valley Gastroenterology Inc.

  dba Gastroenterology of the Rockies

  • Gastroenterology Physician
  • Lafayette, CO
  • NPI 1902832603
  Medicare reassignment NPD
• North Denver Anesthesia Associates, LLC

  • Certified Registered Nurse Anesthetist
  • Boulder, CO
  • NPI 1902624422

  Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD
• Boulder Valley Gastroenterology Inc.

  dba Gastroenterology of the Rockies

  • Gastroenterology Physician
  • Northglenn, CO
  • NPI 1043806276
  NPD

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

{
    "created_epoch": "1434672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583366400000",
    "number": "1427430032",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "382 S ARTHUR AVE",
            "city": "LOUISVILLE",
            "state": "CO",
            "postal_code": "800273094",
            "telephone_number": "303-604-5000",
            "fax_number": "720-890-0364"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1755 48TH ST STE 100",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803012712",
            "telephone_number": "303-604-5000",
            "fax_number": "720-890-0364"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAHRBACH",
        "first_name": "MARISSA",
        "middle_name": "LEE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-06-19",
        "last_updated": "2020-03-05",
        "certification_date": "2020-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "KS",
            "license": "103068",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "KS",
            "license": "557356",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "CO",
            "license": "0994226",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARISSSA",
            "last_name": "BENSON",
            "middle_name": "LEE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Eye on Living, Inc.
• Ashley Eyre
• Landrey Fagan, MD
• Kacey Marie Fagler, PHARMD
• Brenda Fahn
• Robyn Faike, CMT
• Lorraine Higbie Fairmont, CNM, MSN, CLC
• Linda Stephanie Falb, OT
• Mary Faltynski, RN
• Family First Vision Care Colorado LLC

• Certified Registered Nurse Anesthetist in Boulder, CO
• Providers in Boulder, CO by specialty
• Certified Registered Nurse Anesthetist in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.