Marilyn Nishitani, CFNP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

R35362 Issued in NM

Practice address

1112 N Main St
Roswell, NM 88201-5010

Phone

(575) 627-4200

Fax

(575) 627-4212

NPI assigned

Aug 16, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Immedicare Care Clinic PC

  • Family Medicine Physician
  • Ruidoso, NM
  • NPI 1942292149
  NPD (past) Authorized official
• Alteon Health New Mexico LLC

  • Emergency Medicine Physician
  • Hobbs, NM
  • NPI 1457636706

  Nurse Practitioner

  NPD (past)
• Eddy Emergency Group LLC

  • Emergency Medicine Physician
  • Carlsbad, NM
  • NPI 1568487395

  Nurse Practitioner

  NPD (past)
• Lea Emergency Group LLC

  • Emergency Medicine Physician
  • Hobbs, NM
  • NPI 1063521938

  Nurse Practitioner

  NPD (past)
• Roswell Clinic Corp

  • Family Medicine Physician
  • Roswell, NM
  • NPI 1649267618
  NPD (past)

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

{
    "created_epoch": "1124150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1454630400000",
    "number": "1629060835",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1112 N MAIN ST",
            "city": "ROSWELL",
            "state": "NM",
            "postal_code": "882015010",
            "telephone_number": "575-627-4200",
            "fax_number": "575-627-4212"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1112 N MAIN ST",
            "city": "ROSWELL",
            "state": "NM",
            "postal_code": "882015010",
            "telephone_number": "575-627-4200",
            "fax_number": "575-627-4212"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NISHITANI",
        "first_name": "MARILYN",
        "credential": "CFNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-16",
        "last_updated": "2016-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NM",
            "license": "R35362",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "S4973",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• New Mexico Speech and Swallowing Services, LLC
• Newmex Case Management, LLC
• Next Phase Inc.
• Next Phase, Inc.
• Leandra J Nier, ACNP-BC
• NM Dentistry PC
• Nmu-Roswell Roswell High School SBHC
• Nmva LLC
• David Noriega
• Steven Craig North, M.D.

• Nurse Practitioner in Roswell, NM
• Providers in Roswell, NM by specialty
• Nurse Practitioner in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2016; 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.