Individual provider Active NPI

Mary Morrison, FNP

  • Family Nurse Practitioner
  • Truckee, CA
National Provider Identifier
1639152242
Registry record updated Aug 6, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
4436 Issued in CA
Practice address
10833 Donner Pass Rd
Suite 101
Truckee, CA 96161-4851
Phone
(530) 582-8535
Fax
(530) 582-8841
NPI assigned
Nov 29, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2008

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X K222165 CA
Family Nurse Practitioner 363LF0000X 4436 CA Primary

Addresses

Primary practice location

10833 Donner Pass Rd
Suite 101
Truckee, CA 96161-4851

Mailing address

10833 Donner Pass Rd
Suite 101
Truckee, CA 96161-4851
Phone (530) 582-8535

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20050607001243 CA Practitioner - Nurse Practitioner 5496798779 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
K222165CAMDLicensed Practical Nurse
4436CAMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Eastern Plumas Health Care Home Health CurrentSince Apr 17, 2018 Accepting new patients
Eastern Plumas Health Care District CurrentSince Apr 17, 2018 Accepting new patients
Gi Associates Past Accepting new patients

Locations

480 1st Ave
Portola, CA 96122
Phone (530) 832-6600

500 1st Ave
Portola, CA 96122
Phone (530) 832-4277

Interoperability endpoints

  • Direct secure messaging: mmorrison@ephc.securechart.com

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": "1133222400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1217980800000",
    "number": "1639152242",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10833 DONNER PASS RD",
            "address_2": "SUITE 101",
            "city": "TRUCKEE",
            "state": "CA",
            "postal_code": "961614851",
            "telephone_number": "530-582-8535",
            "fax_number": "530-582-8841"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10833 DONNER PASS RD",
            "address_2": "SUITE 101",
            "city": "TRUCKEE",
            "state": "CA",
            "postal_code": "961614851",
            "telephone_number": "530-582-8535",
            "fax_number": "530-582-8841"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORRISON",
        "first_name": "MARY",
        "name_prefix": "Ms.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-29",
        "last_updated": "2008-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "CA",
            "license": "K222165",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "4436",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Truckee, CA

Sources for this page

Verify at the official NPI Registry.