Individual provider Active NPI

Marcia Katonya Roberts-Morris, ARNP

  • Primary Care Nurse Practitioner
  • Monticello, FL
National Provider Identifier
1669886743
Registry record updated Nov 9, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
9328762 Issued in FL
Practice address
710 Ash St
Monticello, FL 32344-2100
Phone
(850) 212-0127
NPI assigned
Jun 17, 2014
Last updated
Nov 9, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 9, 2015

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse Practitioner 363LP2300X 9328762 FL Primary
Registered Nurse 163W00000X RN9328762 FL
Registered Nurse 163W00000X RN219851 GA

Addresses

Primary practice location

710 Ash St
Monticello, FL 32344-2100

Mailing address

710 Ash St
Monticello, FL 32344-2100
Phone (850) 212-0127

Other names 1

  • Ms. Marcia Katonya Roberts Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20171209000185 FL Practitioner - Nurse Practitioner 5395003883 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

3013 Jim Lee Rd
Tallahassee, FL 32301-7057
Phone (850) 414-5560

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
RN9328762FLMDRegistered Nurse
RN219851GAMDRegistered Nurse
9328762FLMDPrimary Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Neighborhood Medical Center, Inc CurrentSince Jul 1, 2017 Accepting new patients
Neighborhood Medical Center, Inc CurrentSince Jul 1, 2017 Accepting new patients

Locations

1210 Kemp Rd
Havana, FL 32333
Phone (850) 539-0065

604 E 5th Ave
Havana, FL 32333
Phone (850) 224-2469

2295 Pasco St
Tallahassee, FL 32310
Phone (850) 224-2409

3013 Jim Lee Rd
Tallahassee, FL 32301
Phone (850) 391-5585

438 W Brevard St
Tallahassee, FL 32301
Phone (850) 224-2469

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/15524/brand/3/csg/1/fhir/r4
  • Direct secure messaging: marcia.roberts-morris.1@15524.direct.athenahealth.com

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1402963200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1447027200000",
    "number": "1669886743",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "710 ASH ST",
            "city": "MONTICELLO",
            "state": "FL",
            "postal_code": "323442100",
            "telephone_number": "850-212-0127"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "710 ASH ST",
            "city": "MONTICELLO",
            "state": "FL",
            "postal_code": "323442100",
            "telephone_number": "850-212-0127"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTS-MORRIS",
        "first_name": "MARCIA",
        "middle_name": "KATONYA",
        "name_prefix": "Mrs.",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-06-17",
        "last_updated": "2015-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "FL",
            "license": "9328762",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "FL",
            "license": "RN9328762",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "GA",
            "license": "RN219851",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARCIA",
            "last_name": "ROBERTS",
            "middle_name": "KATONYA",
            "prefix": "MS.",
            "credential": "RN, ARNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Monticello, FL

Sources for this page

Verify at the official NPI Registry.