Individual provider Active NPI

Marianne Geiger, MD

  • Psychiatry Physician
  • Newport, OR
National Provider Identifier
1639215015
Registry record updated Jun 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
036076824 Issued in IL
Practice address
730 NE Jeffries PL
Newport, OR 97365-2516
Phone
(815) 262-4294
Fax
(541) 635-5771
NPI assigned
Jan 30, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 20, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Interventional Pain Medicine Physician 208VP0014X 036076824 IL
Psychiatry Physician 2084P0800X 036076824 IL Primary

Addresses

Primary practice location

730 NE Jeffries PL
Newport, OR 97365-2516

Mailing address

730 NE Jeffries PL
Newport, OR 97365-2516
Phone (815) 262-4294

Other practice location 1

1752 Windsor Rd
Suite 203
Loves Park, IL 61111-4280
Phone (815) 986-1113

Other identifiers 1

IdentifierTypeStateIssuer
K14296MedicaidIL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
036076824ILMDInterventional Pain Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Progressive Chiropractic Wellness & Rehab Centre, P.C. PastSince Jan 1, 2005 Accepting new patients

Organizations & group practices 1

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": "1170115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655683200000",
    "number": "1639215015",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "730 NE JEFFRIES PL",
            "city": "NEWPORT",
            "state": "OR",
            "postal_code": "973652516",
            "telephone_number": "815-262-4294",
            "fax_number": "541-635-5771"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "730 NE JEFFRIES PL",
            "city": "NEWPORT",
            "state": "OR",
            "postal_code": "973652516",
            "telephone_number": "815-262-4294",
            "fax_number": "541-635-5771"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1752 Windsor Rd",
            "address_2": "Suite 203",
            "address_purpose": "LOCATION",
            "city": "Loves Park",
            "state": "IL",
            "postal_code": "611114280",
            "country_code": "US",
            "telephone_number": "815-986-1113",
            "fax_number": "815-986-1119",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GEIGER",
        "first_name": "MARIANNE",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-30",
        "last_updated": "2022-06-20",
        "certification_date": "2022-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208VP0014X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "IL",
            "license": "036076824",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "IL",
            "license": "036076824",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "K14296",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Newport, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2022; 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.