Marcella Massenburg Atwater, PMHCNS-BC

Primary specialty

Adult Psychiatric/Mental Health Clinical Nurse SpecialistTaxonomy code 364SP0809X

License

69765 Issued in NC

Practice address

1008 Bowler Dr
Durham, NC 27703-6311

Phone

(919) 687-4013

Fax

(919) 680-4010

NPI assigned

Oct 15, 2008

Sex

Female

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Specialist

State licenses

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

{
    "created_epoch": "1224028800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1411084800000",
    "number": "1700038353",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1008 BOWLER DR",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277036311",
            "telephone_number": "919-687-4013",
            "fax_number": "919-680-4010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1008 BOWLER DR",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277036311",
            "telephone_number": "919-687-4013",
            "fax_number": "919-680-4010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ATWATER",
        "first_name": "MARCELLA",
        "middle_name": "MASSENBURG",
        "name_prefix": "Ms.",
        "credential": "PMHCNS-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-10-15",
        "last_updated": "2014-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0809X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health, Adult",
            "state": "NC",
            "license": "069765",
            "primary": false
        },
        {
            "code": "364SP0809X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Psychiatric/Mental Health, Adult",
            "state": "NC",
            "license": "69765",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1700038353",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tamara Bradham Atkinson, LCSW
• Atlantic Family Network
• Atlantic Healthcare Services Inc
• David Edward Attarian, M.D.
• Atterbury Family Care Home
• Sireatta Gibson Atwater, R.PH.
• Leah Sage Atwell, MSW, LCSW
• Phyllis Sage Atwell, M.D.
• Kimberly Quail Atwood, RD, PA-C
• Sandra Au, MD

• Adult Psychiatric/Mental Health Clinical Nurse Specialist in Durham, NC
• Providers in Durham, NC by specialty
• Adult Psychiatric/Mental Health Clinical Nurse Specialist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2014; 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.