Individual provider Active NPI

Marion Talam

  • Psychiatric/Mental Health Nurse Practitioner
  • Mesquite, TX
National Provider Identifier
1629794714
Registry record updated Jul 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
1096948 Issued in TX
Practice address
18601 LBJ Fwy Ste 619D
Mesquite, TX 75150-5615
Phone
(763) 321-9478
NPI assigned
Oct 19, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 20, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 1096948 TX Primary

Addresses

Primary practice location

18601 LBJ Fwy Ste 619D
Mesquite, TX 75150-5615

Mailing address

18601 LBJ Fwy Ste 619D
Mesquite, TX 75150-5615
Phone (469) 630-8830

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20230930000280 TX Practitioner - Nurse Practitioner 2264886837 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
1096948TXMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Grow Healthcare Group PA Psychiatric/Mental Health CurrentSince Jul 19, 2024 Accepting new patients
Ace Care Healthcare Services Inc PastSince Oct 1, 2022 Accepting new patients
Ace Care Staffing Inc PastSince Oct 1, 2022 Accepting new patients

Locations

66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711

700 Milam St
Ste 1300
Houston, TX 77002
Phone (281) 801-8391

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1666137600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689811200000",
    "number": "1629794714",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18601 LBJ FWY STE 619D",
            "city": "MESQUITE",
            "state": "TX",
            "postal_code": "751505615",
            "telephone_number": "469-630-8830"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18601 LBJ FWY STE 619D",
            "city": "MESQUITE",
            "state": "TX",
            "postal_code": "751505615",
            "telephone_number": "763-321-9478"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TALAM",
        "first_name": "MARION",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-10-19",
        "last_updated": "2023-07-20",
        "certification_date": "2023-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TX",
            "license": "1096948",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesquite, TX

Sources for this page

Verify at the official NPI Registry.