Kelly Marine, PNP

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

C118529 Issued in IA

Practice address

200 Hawkins Dr
Iowa City, IA 52242-1009

Phone

(319) 384-5108

Fax

(319) 356-8443

NPI assigned

Feb 26, 2014

Last updated

Mar 9, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in IA

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kmarine16330@uihcdirect.org

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.

• State University of Iowa

  dba University of Iowa Health Care

  • Family Medicine Physician
  • Iowa City, IA
  • NPI 1477554814
  Medicare reassignment NPD
• Floyd County Memorial Hospital Commission

  • Critical Access Hospital
  • Charles City, IA
  • NPI 1265402390
  NPD (past)
• State University of Iowa

  dba Student Health & Wellness

  • Student Health Clinic/Center
  • Iowa City, IA
  • NPI 1285635664
  NPD (past)

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

{
    "created_epoch": "1393372800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646784000000",
    "number": "1508281619",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 HAWKINS DR",
            "city": "IOWA CITY",
            "state": "IA",
            "postal_code": "522421009",
            "telephone_number": "319-384-5108",
            "fax_number": "319-356-8443"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 HAWKINS DR",
            "city": "IOWA CITY",
            "state": "IA",
            "postal_code": "522421009",
            "telephone_number": "319-384-5108",
            "fax_number": "319-356-8443"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1090 Arnold Dr",
            "address_purpose": "LOCATION",
            "city": "Little Rock AFB",
            "state": "AR",
            "postal_code": "720994933",
            "country_code": "US",
            "telephone_number": "501-987-3080",
            "fax_number": "501-987-7233",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MARINE",
        "first_name": "KELLY",
        "credential": "PNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-02-26",
        "last_updated": "2022-03-09",
        "certification_date": "2022-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IA",
            "license": "C118529",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "IA",
            "license": "C118529",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IA",
            "license": "118529",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Maria Conley D C P C (Conley Chiropractic)
• Nithula Mariam Jose
• Anil Marian, MD
• Paolo Marilim, DPT
• Anthony John Marincovich, MD
• Michael Christian Marinier, MD
• Matthew Markert, PHARM D.
• Dane J Markham
• Daniel Christopher Marko, MD
• Jessie Marks, M.D.

• Pediatric Nurse Practitioner in Iowa City, IA
• Providers in Iowa City, IA by specialty
• Pediatric Nurse Practitioner in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.