Marlene Joan Margerum, NP

Primary specialty

Primary Care Nurse PractitionerTaxonomy code 363LP2300X

License

R158868 Issued in MD

Practice address

6052 Augustine Ave
Elkridge, MD 21075-5351

Phone

(443) 820-7565

NPI assigned

Sep 6, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Nurse Practitioner

State licenses

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

{
    "created_epoch": "1599350400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599350400000",
    "number": "1558975508",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6052 AUGUSTINE AVE",
            "city": "ELKRIDGE",
            "state": "MD",
            "postal_code": "210755351",
            "telephone_number": "443-820-7565"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6052 AUGUSTINE AVE",
            "city": "ELKRIDGE",
            "state": "MD",
            "postal_code": "210755351",
            "telephone_number": "443-820-7565"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARGERUM",
        "first_name": "MARLENE",
        "middle_name": "JOAN",
        "name_prefix": "Miss",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-09-06",
        "last_updated": "2020-09-06",
        "certification_date": "2020-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "MD",
            "license": "R158868",
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "MD",
            "license": "R158868",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Primary Care Nurse Practitioner in Elkridge, MD
• Providers in Elkridge, MD by specialty
• Primary Care Nurse Practitioner in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2020; 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.