Kelly A. Maris-Weissburg, R.N.N.P.

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

296076 Issued in CA

Practice address

80 Grand Ave Ste 602
Oakland, CA 94612-3744

Phone

(510) 763-0884

Fax

(510) 763-8753

NPI assigned

Jul 27, 2006

Last updated

Jul 8, 2007By the provider in NPPES

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1153958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1629092945",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "775 SILVER OAKS PL",
            "city": "WALNUT CREEK",
            "state": "CA",
            "postal_code": "945972682",
            "telephone_number": "925-979-1297"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "80 GRAND AVE STE 602",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946123744",
            "telephone_number": "510-763-0884",
            "fax_number": "510-763-8753"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARIS-WEISSBURG",
        "first_name": "KELLY",
        "middle_name": "A.",
        "credential": "R.N.N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "296076",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Benjamin Maring, M.D.
• Preston J. Maring, MD
• Tara Elizabeth Marino, RD
• David N Marinoff, M.D., F.A.C.O.G
• Ankhesenamun Ball Marioni, PSY.D
• Marina Mariscal Padilla
• Mark David Levine, MD Oakland PC (Community Psychiatry Associates)
• Mark M Ting Dental Coporation
• Mark Tavakoli DDS Dental Corporation (Mark Tavakoli DDs Dental Corp)
• Mark Tavakoli DDS Dental Corporation

• Nurse Practitioner in Oakland, CA
• Providers in Oakland, CA by specialty
• Nurse Practitioner in California

• 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.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.