Individual provider Active NPI

Johnna Marr

  • Psychiatric/Mental Health Nurse Practitioner
  • Bowling Green, KY
National Provider Identifier
1457995839
Registry record updated Oct 29, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
3014000 Issued in KY
Practice address
1035 Porter Pike
Bowling Green, KY 42103-9581
Phone
(270) 843-1199
NPI assigned
Oct 29, 2019
Last updated
Oct 29, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 3014000 KY Primary

Addresses

Primary practice location

1035 Porter Pike
Bowling Green, KY 42103-9581

Mailing address

173 Marr Perkins Rd
Scottsville, KY 42164-7449
Phone (270) 618-0644

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
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
I20200504001202 KY Practitioner - Nurse Practitioner 0042641284 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Uhs of Bowling Green LLC CurrentSince May 1, 2020 Accepting new patients
Oaks Behavioral Health PLLC Psychiatric/Mental Health CurrentSince Oct 1, 2020 Accepting new patients

Locations

1035 Porter Pike
Bowling Green, KY 42103
Phone (270) 843-1199

100 S Broadway St
Glasgow, KY 42141
Phone (270) 585-6604

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": "1572307200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1572307200000",
    "number": "1457995839",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "173 MARR PERKINS RD",
            "city": "SCOTTSVILLE",
            "state": "KY",
            "postal_code": "421647449",
            "telephone_number": "270-618-0644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1035 PORTER PIKE",
            "city": "BOWLING GREEN",
            "state": "KY",
            "postal_code": "421039581",
            "telephone_number": "270-843-1199"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARR",
        "first_name": "JOHNNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-10-29",
        "last_updated": "2019-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "KY",
            "license": "3014000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bowling Green, KY

Sources for this page

Verify at the official NPI Registry.