Individual provider Active NPI

Marissa Linn Jovicic, FNP

  • Family Nurse Practitioner
  • Wheeling, WV
National Provider Identifier
1437500469
Registry record updated Jun 30, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN85579-NP-C Issued in WV
Practice address
58 16TH St
Wheeling, WV 26003-3660
Phone
(304) 243-8452
NPI assigned
Jun 30, 2016
Last updated
Jun 30, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2016

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 APRN85579-NP-C WV Primary

Addresses

Primary practice location

58 16TH St
Wheeling, WV 26003-3660

Mailing address

59648 Broadview Rd
Shadyside, OH 43947-9771
Phone (304) 281-4714

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV, OH2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20161005000345 WV Practitioner - Nurse Practitioner 9638467723 Reassigns benefits to 1 organization
I20210726003016 OH Practitioner - Nurse Practitioner 9638467723 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Valley Hospice IncGroup PAC ID 4183637069, 3 clinicians

Practice addresses (Care Compare)

308 Mount Saint Joseph Rd
Wheeling, WV 26003-2349
Phone (304) 242-1977

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
APRN85579-NP-CWVMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Valley Hospice Inc. CurrentSince May 6, 2021 Accepting new patients

Locations

10686 State Route 150
Rayland, OH 43943
Phone (740) 859-5650

4000 Johnson Rd
Wintersville, OH 43952
Phone (740) 264-8011

308 Mount Saint Joseph Rd
Wheeling, WV 26003
Phone (304) 242-1977

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": "1467244800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1467244800000",
    "number": "1437500469",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "59648 BROADVIEW RD",
            "city": "SHADYSIDE",
            "state": "OH",
            "postal_code": "439479771",
            "telephone_number": "304-281-4714"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "58 16TH ST",
            "city": "WHEELING",
            "state": "WV",
            "postal_code": "260033660",
            "telephone_number": "304-243-8452"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOVICIC",
        "first_name": "MARISSA",
        "middle_name": "LINN",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-30",
        "last_updated": "2016-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WV",
            "license": "APRN85579-NP-C",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wheeling, WV

Sources for this page

Verify at the official NPI Registry.