Individual provider Active NPI

Elizabeth Marks, NP

  • Nurse Practitioner
  • Wrentham, MA
National Provider Identifier
1629020466
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
163666 Issued in MA
Practice address
131 Emerald St
Wrentham Developmental Center
Wrentham, MA 02093-1902
Phone
(508) 384-3114
Fax
(508) 384-8938
NPI assigned
May 17, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 163666 MA Primary

Addresses

Primary practice location

131 Emerald St
Wrentham Developmental Center
Wrentham, MA 02093-1902

Mailing address

131 Emerald St
Wrentham Developmental Center
Wrentham, MA 02093-1902
Phone (508) 384-3114

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)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
163666MAMDNurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1147824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1629020466",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "131 EMERALD ST",
            "address_2": "WRENTHAM DEVELOPMENTAL CENTER",
            "city": "WRENTHAM",
            "state": "MA",
            "postal_code": "020931902",
            "telephone_number": "508-384-3114",
            "fax_number": "508-384-8938"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "131 EMERALD ST",
            "address_2": "WRENTHAM DEVELOPMENTAL CENTER",
            "city": "WRENTHAM",
            "state": "MA",
            "postal_code": "020931902",
            "telephone_number": "508-384-3114",
            "fax_number": "508-384-8938"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARKS",
        "first_name": "ELIZABETH",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-17",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MA",
            "license": "163666",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wrentham, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.