Katie L Marsh, PA
Individual provider Active NPI Physician Assistant · Galena, KS
NPI 1528095973 · NPPES record last updated Mar 5, 2014
Key facts
- NPI
- 1528095973
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- License
- 1501358 (KS)
- Practice address
- 444 Four States Dr
Suite 1
Galena, KS 66739 - Phone
- (620) 783-4441
- Fax
- (620) 783-4090
- NPI assigned
- Jun 28, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 5
Hospital & facility affiliations 4
Medicare Care Compare profile
- Specialty
- Physician Assistant
- Education
- Other, 2004
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Mercy Clinic Joplin LLC
Practice addresses (Care Compare)
100 Mercy Way
Joplin, MO 64804-4524
1619
K66
Galena, KS 66739-4306
Phone (417) 781-4404
1717 S Range Line Rd B
Joplin, MO 64804-3224
220 N Pennsylvania Ave
Columbus, KS 66725-1110
3125 Dr Russell Smith Way
Carthage, MO 64836-7402
403 Woodland Hills Blvd
Mercy Clinic Radiology
Fort Scott, KS 66701-8798
Phone (417) 556-4762
444 Four States Dr
Suite 1
Galena, KS 66739-4325
Phone (877) 783-4441
94 Main St
Cassville, MO 65625-1610
Phone (417) 782-7722
Hospital & facility affiliations
- Mercy Specialty Hospital Southeast Kansas
- Mercy Hospital Joplin
- Mercy Hospital Carthage
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in MO, KS
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20070214000013 | MO | Practitioner - Physician Assistant | 3476594607 | Reassigns benefits to 1 organization |
| I20100309000074 | KS | Practitioner - Physician Assistant | 3476594607 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1501358 | KS | MD | Physician Assistant |
| 2005004536 | MO | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mercy Clinic Joplin LLC | Current |
Accepting new patients | |
| Mercy Clinic Joplin LLC | Current |
Accepting new patients | |
| Orthopaedic Specialists of the Four States LLC | Past | Accepting new patients |
Locations
444 Four States Dr
Ste 1
Galena, KS 66739
Phone (877) 783-4441
3125 Dr Russell Smith Way
Carthage, MO 64836
Phone (417) 358-8121
100 Mercy Way
Joplin, MO 64804
Phone (417) 556-2300
Interoperability endpoints
- kmarsh1057078@directc.mercy.net
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 2005004536 | MO | |
| Physician Assistant | 363A00000X | 1501358 | KS | Yes |
Addresses
Primary practice location
444 Four States Dr
Suite 1
Galena, KS 66739
Mailing address
PO Box 2546
Joplin, MO 64803-2546
Phone (620) 783-4441
Other providers in Galena, KS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 5, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.