Individual provider Active NPI

Marissa Carol Hyatt, AGACNP-BC

  • Nurse Practitioner
  • Mooresville, NC
National Provider Identifier
1700452943
Registry record updated Mar 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
5015825 Issued in NC
Practice address
134 Medical Park Rd Ste 200
Mooresville, NC 28117-8527
Phone
(980) 302-7800
Fax
(980) 302-7805
NPI assigned
May 28, 2021
Last updated
Mar 9, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 9, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 5015825 NC Primary
Acute Care Nurse Practitioner 363LA2100X 2019015811 NC

Addresses

Primary practice location

134 Medical Park Rd Ste 200
Mooresville, NC 28117-8527

Mailing address

PO Box 60447
Charlotte, NC 28260-0447
Phone (980) 302-7800

Other practice location 1

116 Taylors Creek St
Mount Holly, NC 28120-9078
Phone (803) 487-5887

Other practice location 2

106 Corporate Park Dr Ste 200&300
Mooresville, NC 28117-7133
Phone (704) 887-4530

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20220406000012 NC Practitioner - Nurse Practitioner 0345636031 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Catawba Valley Medical Group IncGroup PAC ID 6305007279, 133 clinicians

Practice addresses (Care Compare)

3521 Graystone PL SE
Suite 202
Conover, NC 28613-8269
Phone (828) 732-5700

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5015825NCMDNurse Practitioner
2019015811NCMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
The Presbyterian Hospital Current Accepting new patients
The Presbyterian Hospital CurrentSince Apr 23, 2022 Accepting new patients
Catawba Valley Medical Center Current Accepting new patients
Novant Health Medical Group, LLC Current Accepting new patients
Novant Health Medical Group, LLC CurrentSince Apr 23, 2022 Accepting new patients
Novant Health Medical Group, LLC Current Accepting new patients
Novant Health Medical Group, LLC CurrentSince Apr 23, 2022 Accepting new patients
Novant Health Medical Group, LLC CurrentSince Apr 23, 2022 Accepting new patients
Catawba Valley Medical Center CurrentSince Aug 4, 2025 Accepting new patients
Catawba Valley Medical Group Inc CurrentSince Aug 4, 2025 Accepting new patients
The Presbyterian Hospital CurrentSince Apr 23, 2022 Accepting new patients
Catawba Valley Medical Group, Inc CurrentSince Aug 4, 2025 Accepting new patients
Catawba Valley Medical Group, Inc Current Accepting new patients
Catawba Valley Medical Center CurrentSince Aug 4, 2025 Accepting new patients
Catawba Valley Medical Group Inc Past Accepting new patients

Locations

200 Rosenwald School St
Catawba, NC 28609
Phone (828) 241-2377

125 Baldwin Ave
Ste 200
Charlotte, NC 28204
Phone (704) 384-5043

125 Queens Rd
Ste 250
Charlotte, NC 28204
Phone (704) 316-2340

301 Hawthorne Ln
Ste 200
Charlotte, NC 28204
Phone (704) 316-5100

6324 Fairview Rd
Ste 330
Charlotte, NC 28210
Phone (704) 316-2670

8201 Healthcare Loop
Ste 201
Charlotte, NC 28215
Phone (704) 316-3024

3521 Graystone Pl SE
Ste 202
Conover, NC 28613
Phone (828) 326-2354

810 Fairgrove Church Rd
Hickory, NC 28602
Phone (704) 326-3000

10030 Gilead Rd
Ste 201
Huntersville, NC 28078
Phone (704) 598-6042

1401 Matthews Township Pkwy
Ste 110
Matthews, NC 28105
Phone (704) 264-3500

1401 Matthews Township Pkwy
Ste 212312
Matthews, NC 28105
Phone (704) 316-3131

106 Corporate Park Dr
Ste 200300
Mooresville, NC 28117
Phone (704) 235-9090

134 Medical Park Rd
Ste 200
Mooresville, NC 28117
Phone (704) 384-7972

5145 Sellers Rd
Shallotte, NC 28470
Phone (910) 754-4441

50 Macedonia Church Rd
#A
Taylorsville, NC 28681
Phone (828) 732-5300

2825 Lyndhurst Ave
Ste 101
Winston Salem, NC 27103
Phone (336) 277-6300

Interoperability endpoints

  • Direct secure messaging: marisa.hyatt@cvmg.eclinicaldirectplus.com

Organizations & group practices 15

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.

View all 15

Hospital & facility affiliations 1

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": "1622160000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678320000000",
    "number": "1700452943",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 60447",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282600447",
            "telephone_number": "980-302-7800",
            "fax_number": "980-302-7805"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "134 MEDICAL PARK RD STE 200",
            "city": "MOORESVILLE",
            "state": "NC",
            "postal_code": "281178527",
            "telephone_number": "980-302-7800",
            "fax_number": "980-302-7805"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "116 Taylors Creek St",
            "address_purpose": "LOCATION",
            "city": "Mount Holly",
            "state": "NC",
            "postal_code": "281209078",
            "country_code": "US",
            "telephone_number": "803-487-5887",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "106 Corporate Park Dr Ste 200&300",
            "address_purpose": "LOCATION",
            "city": "Mooresville",
            "state": "NC",
            "postal_code": "281177133",
            "country_code": "US",
            "telephone_number": "704-887-4530",
            "fax_number": "704-887-4531",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HYATT",
        "first_name": "MARISSA",
        "middle_name": "CAROL",
        "name_prefix": "Mrs.",
        "credential": "AGACNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-05-28",
        "last_updated": "2023-03-09",
        "certification_date": "2023-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": "5015825",
            "primary": true
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "NC",
            "license": "2019015811",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mooresville, NC

Sources for this page

Verify at the official NPI Registry.