Individual provider Active NPI

Robert Gordon Marsh, ARNP

  • Family Nurse Practitioner
  • Fordland, MO
National Provider Identifier
1679570287
Registry record updated Dec 27, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN 105886 Issued in MO
Practice address
1059 Barton Dr
Fordland, MO 65652-7350
Phone
(417) 767-2273
Fax
(417) 767-4054
NPI assigned
Jun 29, 2005
Last updated
Dec 27, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 27, 2019

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X ARNP 938462 FL
Family Nurse Practitioner 363LF0000X RN 105886 MO Primary
Gerontology Nurse Practitioner 363LG0600X RN105886 MO
Gerontology Nurse Practitioner 363LG0600X ARNP 938462 FL

Addresses

Primary practice location

1059 Barton Dr
Fordland, MO 65652-7350

Mailing address

718 Patterson Rd
Rogersville, MO 65742-8096
Phone (417) 753-7084

Other identifiers 1

IdentifierTypeStateIssuer
428189617MedicaidMO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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
I20040922000310 MO Practitioner - Nurse Practitioner 3274501713 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Fordland Clinic, Inc.Group PAC ID 5597794552, 10 clinicians
Cherry Health Center, LLCGroup PAC ID 1355317033, 97 clinicians

Practice addresses (Care Compare)

1059 Barton Dr
Fordland, MO 65652-7350
Phone 41776722732022

607 W Battlefield St
Springfield, MO 65807-4123
Phone (417) 869-2000

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ARNP 938462FLMDFamily Nurse Practitioner
RN 105886MOMDFamily Nurse Practitioner
RN105886MOMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Lester E Cox Medical Centers CurrentSince Feb 1, 2019 Accepting new patients
Fordland Clinic, Inc. CurrentSince Jan 3, 2011 Accepting new patients
Lester E. Cox Medical Centers Current Accepting new patients
Lester E Cox Medical Centers CurrentSince Feb 1, 2019 Accepting new patients
Fordland Clinic, Inc. CurrentSince Jan 3, 2011 Accepting new patients
Lester E Cox Medical Centers CurrentSince Feb 1, 2019 Accepting new patients
Doctors Hearing Center LLC XLLG Past Accepting new patients
Ozarks Medical Center Past Accepting new patients

Locations

1059 Barton Dr
Fordland, MO 65652
Phone (417) 767-2100

11863 State Highway 13
Ste 1
Kimberling City, MO 65686
Phone (417) 739-2520

5100 N Towne Centre Dr
Ozark, MO 65721
Phone (417) 269-2215

3801 S National Ave
Springfield, MO 65807
Phone (417) 269-4056

Interoperability endpoints

  • Direct secure messaging: rmarsh@11ef84f8.micromddirect.com

Organizations & group practices 9

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": "1120003200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1577404800000",
    "number": "1679570287",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "718 PATTERSON RD",
            "city": "ROGERSVILLE",
            "state": "MO",
            "postal_code": "657428096",
            "telephone_number": "417-753-7084",
            "fax_number": "417-767-4054"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1059 BARTON DR",
            "city": "FORDLAND",
            "state": "MO",
            "postal_code": "656527350",
            "telephone_number": "417-767-2273",
            "fax_number": "417-767-4054"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARSH",
        "first_name": "ROBERT",
        "middle_name": "GORDON",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-29",
        "last_updated": "2019-12-27",
        "certification_date": "2019-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "ARNP 938462",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "RN 105886",
            "primary": true
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "MO",
            "license": "RN105886",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "FL",
            "license": "ARNP 938462",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "428189617",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fordland, MO

Sources for this page

Verify at the official NPI Registry.