Individual provider Active NPI

David W. Marden, DO

  • Obstetrics & Gynecology Physician
  • Bristol, TN
National Provider Identifier
1699778605
Registry record updated Nov 30, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
DO 1214 Issued in TN
Practice address
1 Medical Park Blvd Ste 305E
Bristol, TN 37620-7450
Phone
(423) 844-5640
Fax
(423) 844-5645
NPI assigned
May 23, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 30, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X DO 1214 TN Primary

Addresses

Primary practice location

1 Medical Park Blvd Ste 305E
Bristol, TN 37620-7450

Mailing address

1 Medical Park Blvd Ste 305E
Bristol, TN 37620-7450
Phone (423) 844-5640

Other identifiers 2

IdentifierTypeStateIssuer
1699778605MedicaidVA
1509780MedicaidTN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040902000585 TN Practitioner - Obstetrics/Gynecology 4486620309 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
College of Osteo Med of the Pacific at Pomona, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1 Medical Park Blvd
Suite 305E
Bristol, TN 37620-7450
Phone (423) 844-5640

Hospital & facility affiliations

  • Wellmont Bristol Regional Medical Center Hospital, Bristol, TN, CCN 440012
  • Johnson City Medical Center Hospital, Johnson City, TN, CCN 440063
  • Wellmont Holston Valley Medical Center Hospital, Kingsport, TN, CCN 440017
  • Johnston Memorial Hospital Hospital, Abingdon, VA, CCN 490053
  • Clinch Valley Medical Center Hospital, Richlands, VA, CCN 490060

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
DO 1214TNMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Marden Medical, PLLC CurrentSince Nov 12, 2009 Accepting new patients

Locations

1 Medical Park Blvd
Ste 305E
Bristol, TN 37620
Phone (423) 279-1400

Interoperability endpoints

  • Direct secure messaging: david.marden.1@2683.direct.athenahealth.com

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.

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1116806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1480464000000",
    "number": "1699778605",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 MEDICAL PARK BLVD STE 305E",
            "city": "BRISTOL",
            "state": "TN",
            "postal_code": "376207450",
            "telephone_number": "423-844-5640",
            "fax_number": "423-844-5645"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 MEDICAL PARK BLVD STE 305E",
            "city": "BRISTOL",
            "state": "TN",
            "postal_code": "376207450",
            "telephone_number": "423-844-5640",
            "fax_number": "423-844-5645"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARDEN",
        "first_name": "DAVID",
        "middle_name": "W.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-05-23",
        "last_updated": "2016-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "TN",
            "license": "DO 1214",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1699778605",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1509780",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bristol, TN

Sources for this page

Verify at the official NPI Registry.