Active NPI
Marsha Bosseau, RN
- Registered Nurse First Assistant
- Valparaiso, IN
National Provider Identifier
1497467435
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse First Assistant
- License
- 041411812
- Practice address
- 5 Washington St
Valparaiso, IN 46383-4768 - Phone
- (708) 299-0412
- NPI assigned
- Dec 21, 2022
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse First Assistant | 163WR0006X | 041411812 | IL | Primary |
Addresses
Primary practice location
5 Washington St
Valparaiso, IN 46383-4768
Mailing address
16008 Sawyer Ave
Markham, IL 60428-4528
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 041411812 | Other | IL | STATES OF ILL |
| 041.411812 | Other | IL | STATE OF ILLINOIS |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| FHIR URL | WASHIGTON | Other |
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)
- Not enrolled
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 041411812 | IL | MD | Registered Nurse First Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1671580800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1671580800000",
"number": "1497467435",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "16008 SAWYER AVE",
"city": "MARKHAM",
"state": "IL",
"postal_code": "604284528"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5 WASHINGTON ST",
"city": "VALPARAISO",
"state": "IN",
"postal_code": "463834768",
"telephone_number": "708-299-0412"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOSSEAU",
"first_name": "MARSHA",
"credential": "RN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-12-21",
"last_updated": "2022-12-21",
"certification_date": "2022-12-21",
"status": "A"
},
"taxonomies": [
{
"code": "163WR0006X",
"taxonomy_group": "",
"desc": "Registered Nurse, Registered Nurse First Assistant",
"state": "IL",
"license": "041411812",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATES OF ILL",
"identifier": "041411812",
"state": "IL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE OF ILLINOIS",
"identifier": "041.411812",
"state": "IL"
}
],
"endpoints": [
{
"endpointType": "FHIR",
"endpointTypeDescription": "FHIR URL",
"endpoint": "WASHIGTON",
"affiliation": "N",
"endpointDescription": "OFFICE",
"use": "OTHER",
"useDescription": "Other",
"useOtherDescription": "INFO",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "WASHIGTON",
"address_1": "5 Washington St",
"city": "Valparaiso",
"state": "IN",
"country_code": "US",
"postal_code": "463834768",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Valparaiso, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.