Organization Active NPI

Marquez Family Medical Center LLC

Doing business as Centro Medico Familiar

  • Primary Care Nurse Practitioner
  • Duluth, GA
National Provider Identifier
1588318711
Registry record updated May 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
Legal business name
MARQUEZ FAMILY MEDICAL CENTER LLC
Doing business as
Centro Medico Familiar
Practice address
3840 Peachtree Industrial Blvd Ste 250
Duluth, GA 30096-5034
Phone
(678) 585-4959
Fax
(470) 395-9127
NPI assigned
Feb 7, 2022
Last updated
May 10, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 10, 2022

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

Authorized official

Name
Dr. Orlin Yared Marquez, DNP, MBA, FNP-BCNPI 1659771434
Title
Medical Director/Ceo
Phone
(678) 585-4959

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse Practitioner 363LP2300X NU Primary

Addresses

Primary practice location

3840 Peachtree Industrial Blvd Ste 250
Duluth, GA 30096-5034

Mailing address

3840 Peachtree Industrial Blvd Ste 250
Duluth, GA 30096-5034
Phone (678) 585-4959

Other names 1

  • Centro Medico Familiar Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://www.konzax.org/cgi-bin/login.cgi Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220324000940 GA Part B Supplier - Clinic/Group Practice 8921493131 Receives reassigned benefits from 2 practitioners
Practice locations: Duluth, GA

National Provider Directory

National Provider Directory

Locations

3840 Peachtree Industrial Blvd
Ste 250
Duluth, GA 30096
Phone (678) 524-2730

623 SW 10th Ave
Topeka, KS 66612

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1644192000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1652140800000",
    "number": "1588318711",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3840 PEACHTREE INDUSTRIAL BLVD STE 250",
            "city": "DULUTH",
            "state": "GA",
            "postal_code": "300965034",
            "telephone_number": "678-585-4959",
            "fax_number": "470-395-9127"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3840 PEACHTREE INDUSTRIAL BLVD STE 250",
            "city": "DULUTH",
            "state": "GA",
            "postal_code": "300965034",
            "telephone_number": "678-585-4959",
            "fax_number": "470-395-9127"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARQUEZ FAMILY MEDICAL CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-02-07",
        "last_updated": "2022-05-10",
        "certification_date": "2022-05-10",
        "status": "A",
        "authorized_official_last_name": "MARQUEZ",
        "authorized_official_first_name": "ORLIN",
        "authorized_official_middle_name": "YARED",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR/CEO",
        "authorized_official_telephone_number": "678-585-4959",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DNP, MBA, FNP-BC"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://www.konzax.org/cgi-bin/login.cgi",
            "affiliation": "N",
            "endpointDescription": "HealthE Paradigm",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "623 SW 10th Ave",
            "city": "Topeka",
            "state": "KS",
            "country_code": "US",
            "postal_code": "666121615",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Centro Medico Familiar",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Centro Medico Familiar",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Duluth, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.