Jenica B Marks, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

COA13499NP Issued in OH

Practice address

6450 Weatherfield CT Ste 1a
Maumee, OH 43537-9149

Phone

(419) 360-9747

Fax

(855) 710-6621

NPI assigned

Feb 26, 2009

Last updated

Jun 17, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OH, MI2 enrollments

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 2

Specialty

Nurse Practitioner

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Pure Psychiatry of Michigan PLLCGroup PAC ID 1254741283, 102 clinicians

Promedica Central PhysiciansGroup PAC ID 2365348190, 785 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jenica.marks@620407976427524.direct.elationemr.com

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.

• Pure Psychiatry of Michigan PLLC

  • Physician Assistant
  • Wayne, MI
  • NPI 1831701671
  Medicare reassignment Care Compare group NPD
• Promedica Central Physicians

  • Family Medicine Physician
  • Toledo, OH
  • NPI 1043270150
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1235606400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718582400000",
    "number": "1699915900",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4235 SECOR RD",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "43623",
            "telephone_number": "419-473-3561",
            "fax_number": "517-265-8237"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6450 WEATHERFIELD CT STE 1A",
            "city": "MAUMEE",
            "state": "OH",
            "postal_code": "435379149",
            "telephone_number": "419-360-9747",
            "fax_number": "855-710-6621"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "28442 E River Rd Ste 111",
            "address_purpose": "LOCATION",
            "city": "Perrysburg",
            "state": "OH",
            "postal_code": "435512795",
            "country_code": "US",
            "telephone_number": "419-214-3192",
            "fax_number": "419-214-3195",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MARKS",
        "first_name": "JENICA",
        "middle_name": "B",
        "name_prefix": "Mrs.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-02-26",
        "last_updated": "2024-06-17",
        "certification_date": "2024-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "COA13499NP",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MI",
            "license": "4704264728",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0088231",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Jeremy Paul Marchand, DPM
• Mackenzie Marciniak
• Dolores Walling Mariea, LPCC
• Lauryn Elizabeth Marrufo, RBT
• Marshall-Kloene Orthopedics, Inc.
• Andrea Marie Martin, O.D.
• Jaime Martin, NP
• Kimberly Sue Martin, COTA

• Family Nurse Practitioner in Maumee, OH
• Providers in Maumee, OH by specialty
• Family Nurse Practitioner in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.