Marcia Lynne Shrock, APRN

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

3004426 Issued in KY

Practice address

122 N Watterson TRL
Louisville, KY 40243-2700

Phone

(502) 314-7050

Fax

(502) 245-7992

NPI assigned

Mar 28, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 9

Addresses

Other identifiers 11

Medicare fee-for-service enrollment

Enrolled in KY, OH2 enrollments

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 2

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Community Care Health Network LLC

  • Nurse Practitioner
  • Nashville, TN
  • NPI 1619368842

  KY, OH

  Medicare reassignment
• Home Medical Visits, Inc

  • Clinic/Center
  • Holiday, FL
  • NPI 1639121080

  Adult Health

  NPD (past)

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

{
    "created_epoch": "1175040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627257600000",
    "number": "1548389752",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "122 N WATTERSON TRL",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402432700",
            "telephone_number": "502-314-7050",
            "fax_number": "502-245-7992"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "122 N WATTERSON TRL",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402432700",
            "telephone_number": "502-314-7050",
            "fax_number": "502-245-7992"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHROCK",
        "first_name": "MARCIA",
        "middle_name": "LYNNE",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-28",
        "last_updated": "2021-07-26",
        "certification_date": "2021-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NC",
            "license": "5009232",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "OR",
            "license": "201505322NP-PP",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "ME",
            "license": "CNP151106",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "SC",
            "license": "18795",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "IN",
            "license": "99063696A",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "TX",
            "license": "124312",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NM",
            "license": "02529",
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "OH",
            "license": "COA.14296-NP",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "KY",
            "license": "3004426",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE ARNP LICENSE",
            "identifier": "18795",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OR RN LICENSE",
            "identifier": "201504071RN",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OR NP LICENSE",
            "identifier": "201505322NP-PP",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE APRN LICENSE",
            "identifier": "3004426",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE NP LICENSE",
            "identifier": "COA.14296-NP",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NC NP LICENSE",
            "identifier": "5009232",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100214550",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IN NP LICENSE",
            "identifier": "71005296A",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NP LICENSE",
            "identifier": "CNP151106",
            "state": "ME"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE ARNP LICENSE",
            "identifier": "CNP-02529",
            "state": "NM"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE ARNP LICENSE",
            "identifier": "AP124312",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Anil Kumar Shrestha, MD
• Mary Haley Shrewsbury
• Shri Siddi Vinayaka Drugs Inc
• Brooke Christian Shriner, PHD
• Pavni Shrivastava
• Sandra Kaye Shuburg, RN
• Leeta G. Shuecraft, LCSW
• Alison Faythe Shuff Boswell, DO
• William Thomas Shuffett
• Cheryl Shuffitt, MSN APRN ACNPC-AG

• Adult Health Nurse Practitioner in Louisville, KY
• Providers in Louisville, KY by specialty
• Adult Health Nurse Practitioner in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2021; 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.