Individual provider Active NPI

Lori Rene Marum, ACNP

  • Acute Care Nurse Practitioner
  • Los Angeles, CA
National Provider Identifier
1679840359
Registry record updated Sep 5, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
20596 Issued in CA
Practice address
8635 W 3Rd Street
Suite 675 W
Los Angeles, CA 90048
Phone
(310) 967-4379
NPI assigned
Nov 22, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 5, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 20596 CA Primary

Addresses

Primary practice location

8635 W 3Rd Street
Suite 675 W
Los Angeles, CA 90048

Mailing address

1616 Marlay Dr
Los Angeles, CA 90069-1620
Phone (213) 458-1775

Other identifiers 1

IdentifierTypeStateIssuer
RN368912MedicaidCA

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
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
20596CAMDPhysician Assistant

Interoperability endpoints

  • Direct secure messaging: lcompton100601@direct.cshs.org

NPI Registry JSON

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

{
    "created_epoch": "1321920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1378339200000",
    "number": "1679840359",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1616 MARLAY DR",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900691620",
            "telephone_number": "213-458-1775"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8635 W 3RD STREET",
            "address_2": "SUITE 675 W",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "90048",
            "telephone_number": "310-967-4379"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARUM",
        "first_name": "LORI",
        "middle_name": "RENE",
        "credential": "ACNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-11-22",
        "last_updated": "2013-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "CA",
            "license": "20596",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "RN368912",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2013; 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.