Individual provider Active NPI

Serena Marshall

  • Licensed Practical Nurse
  • Atlanta, GA
National Provider Identifier
1548414618
Registry record updated Nov 15, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
LPN073723 Issued in GA
Practice address
1102 Westchase LN SW
#307
Atlanta, GA 30336-4413
Phone
(678) 334-8040
NPI assigned
Nov 15, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 15, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X LPN073723 GA Primary

Addresses

Primary practice location

1102 Westchase LN SW
#307
Atlanta, GA 30336-4413

Mailing address

PO Box 44424
Atlanta, GA 30336-1424
Phone (678) 334-8040

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

State licenses

LicenseStateTypeSpecialty
LPN073723GAMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1226707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1226707200000",
    "number": "1548414618",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 44424",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303361424",
            "telephone_number": "678-334-8040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1102 WESTCHASE LN SW",
            "address_2": "#307",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303364413",
            "telephone_number": "678-334-8040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARSHALL",
        "first_name": "SERENA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-11-15",
        "last_updated": "2008-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "GA",
            "license": "LPN073723",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.