Colleen Erin Marzilli, FNP-BC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

1058689 Issued in TX

Practice address

2116 E Rusk St
Jacksonville, TX 75766-9052

Phone

(903) 339-3022

Fax

(903) 339-3021

NPI assigned

Nov 15, 2021

Last updated

Nov 16, 2023By 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 2

Addresses

Other identifiers 1

Other names 1

• Dr. Colleen Erin Marzilli Professional name

Medicare fee-for-service enrollment

Enrolled in ME

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Convenientmd - FFS UC LLCGroup PAC ID 5193186492, 397 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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

• Convenientmd - FFS UC LLC

  • Urgent Care Clinic/Center
  • Ellsworth, ME
  • NPI 1780375220
  Medicare reassignment Care Compare group NPD
• St. Joseph Hospital

  • General Acute Care Hospital
  • Bangor, ME
  • NPI 1154321545
  Medicare reassignment
• Convenientmd - FFS UC LLC

  • Urgent Care Clinic/Center
  • Westbrook, ME
  • NPI 1093406530
  NPD
• Convenientmd - FFS UC LLC

  • Urgent Care Clinic/Center
  • Sturbridge, MA
  • NPI 1386526192
  NPD
• Convenientmd - FFS UC LLC

  • Urgent Care Clinic/Center
  • Bangor, ME
  • NPI 1336830868
  NPD (past)

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

{
    "created_epoch": "1636934400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700092800000",
    "number": "1629734660",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "360 US HIGHWAY 1 BYP UNIT 102",
            "city": "PORTSMOUTH",
            "state": "NH",
            "postal_code": "038017105",
            "telephone_number": "603-410-6700",
            "fax_number": "603-319-8308"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2116 E RUSK ST",
            "city": "JACKSONVILLE",
            "state": "TX",
            "postal_code": "757669052",
            "telephone_number": "903-339-3022",
            "fax_number": "903-339-3021"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "543 Broadway",
            "address_purpose": "LOCATION",
            "city": "Bangor",
            "state": "ME",
            "postal_code": "044013337",
            "country_code": "US",
            "telephone_number": "207-922-1300",
            "fax_number": "207-217-6742",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MARZILLI",
        "first_name": "COLLEEN",
        "middle_name": "ERIN",
        "name_prefix": "Dr.",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-11-15",
        "last_updated": "2023-11-16",
        "certification_date": "2023-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "ME",
            "license": "CNP231226",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "1058689",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TEXAS BOARD OF NURSING",
            "identifier": "1058689",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "COLLEEN",
            "last_name": "MARZILLI",
            "middle_name": "ERIN",
            "prefix": "DR.",
            "credential": "PHD, DNP, MBA, RN-BC",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Virginia S Lotito, MS, CCC-SLP
• James Ray Low Jr, MD
• Sarah Lowery, LPC
• Mark Lumpkin, P.T.
• Pamela D Mackay, FNP-C
• May Drug
• Charlene McCauley Mayfield, LPC
• Kathleen Ann McCullough, CRNFA
• Donald Victor McGraw, DO
• Justin M McInnis, MD

• Family Nurse Practitioner in Jacksonville, TX
• Providers in Jacksonville, TX by specialty
• Family Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2023; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.