Individual provider Active NPI

Charity Lynette Marsh, CNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Jefferson City, MO
National Provider Identifier
1538101472
Registry record updated Mar 8, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
141748 Issued in MO
Practice address
1905 Stadium Blvd
Jefferson City, MO 65109-1961
Phone
(888) 403-1071
NPI assigned
Jun 12, 2006
Last updated
Mar 8, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 8, 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 141748 MO Primary

Addresses

Primary practice location

1905 Stadium Blvd
Jefferson City, MO 65109-1961

Mailing address

1800 Community
Clinton, MO 64735-8804
Phone (660) 885-8131

Other practice location 1

1241 W Stadium Blvd
Jefferson City, MO 65109-6023
Phone (573) 635-5264

Other identifiers 2

IdentifierTypeStateIssuer
425791811MedicaidMO
P53614OtherMOUPIN

Other names 1

  • Charity L. Wilson Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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
I20190318000231 MO Practitioner - Nurse Practitioner 4880934538 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Compass Health, Inc CurrentSince Mar 11, 2019 Accepting new patients
Compass Health, Inc CurrentSince Mar 11, 2019 Accepting new patients

Locations

1800 Community
Clinton, MO 64735
Phone (660) 885-8131

1800 Community
#B
Clinton, MO 64735

1905 Stadium Blvd
Jefferson Cty, MO 65109
Phone (573) 634-3000

227 Metro Dr
Jefferson Cty, MO 65109
Phone (573) 634-3000

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": "1150070400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1552003200000",
    "number": "1538101472",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1800 COMMUNITY",
            "city": "CLINTON",
            "state": "MO",
            "postal_code": "647358804",
            "telephone_number": "660-885-8131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1905 STADIUM BLVD",
            "city": "JEFFERSON CITY",
            "state": "MO",
            "postal_code": "651091961",
            "telephone_number": "888-403-1071"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1241 W Stadium Blvd",
            "address_purpose": "LOCATION",
            "city": "Jefferson City",
            "state": "MO",
            "postal_code": "651096023",
            "country_code": "US",
            "telephone_number": "573-635-5264",
            "fax_number": "573-556-1714",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MARSH",
        "first_name": "CHARITY",
        "middle_name": "LYNETTE",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-12",
        "last_updated": "2019-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MO",
            "license": "141748",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "425791811",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UPIN",
            "identifier": "P53614",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CHARITY",
            "last_name": "WILSON",
            "middle_name": "L.",
            "credential": "CPNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Jefferson City, MO

Sources for this page

Verify at the official NPI Registry.