Individual provider Active NPI

Nancy D. Marvin, MSN, RN, NP-C

  • Nurse Practitioner
  • Charlotte, NC
National Provider Identifier
1558804203
Registry record updated Aug 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
5009132 Issued in NC
Practice address
2711 Randolph Rd
BLDG 400
Charlotte, NC 28207-2034
Phone
(704) 348-2992
Fax
(704) 971-0035
NPI assigned
Nov 29, 2016
Last updated
Aug 8, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 8, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 5009132 NC Primary

Addresses

Primary practice location

2711 Randolph Rd
BLDG 400
Charlotte, NC 28207-2034

Mailing address

700 E Morehead St
Ste 300
Charlotte, NC 28202-2742
Phone (704) 362-5391

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address nancymarvin@mnapa.allscriptsdirect.net Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20170306000436 NC Practitioner - Nurse Practitioner 5294019568 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Charlotte Radiology PAGroup PAC ID 4587577390, 222 clinicians

Practice addresses (Care Compare)

1000 Blythe Blvd
Charlotte, NC 28203-5812
Phone (704) 362-1945

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Charlotte Radiology P a CurrentSince Jul 1, 2021 Accepting new patients

Locations

1000 Blythe Blvd
Charlotte, NC 28203
Phone (704) 351-3791

12335 N Community House Rd
Ste B
Charlotte, NC 28277

2711 Randolph Rd
Ste 400
Charlotte, NC 28207
Phone (704) 342-1900

700 E Morehead St
Ste 300
Charlotte, NC 28202
Phone (704) 442-4390

2544 Court Dr
Ste F
Gastonia, NC 28054
Phone (704) 864-8302

724 Aubrey Bell Dr
Matthews, NC 28105
Phone (704) 295-3550

Interoperability endpoints

  • Direct secure messaging: nmarvin487984@carolinashealthcaresystem.direct-ci.com

Organizations & group practices 1

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.

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1480377600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628380800000",
    "number": "1558804203",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 E MOREHEAD ST",
            "address_2": "STE 300",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282022742",
            "telephone_number": "704-362-5391"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2711 RANDOLPH RD",
            "address_2": "BLDG 400",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282072034",
            "telephone_number": "704-348-2992",
            "fax_number": "704-971-0035"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARVIN",
        "first_name": "NANCY",
        "middle_name": "D.",
        "credential": "MSN, RN, NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-11-29",
        "last_updated": "2021-08-08",
        "certification_date": "2021-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": "5009132",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "nancymarvin@mnapa.allscriptsdirect.net",
            "affiliation": "N",
            "endpointDescription": "Allscript Direct Messaging Address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CED",
            "address_1": "2711 Randolph Rd",
            "address_2": "Bldg 400",
            "city": "Charlotte",
            "state": "NC",
            "country_code": "US",
            "postal_code": "282072034",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.