Marianne Dolores McKissick, PAC

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

5601003532 Issued in MI

Practice address

3350 Gratiot Blvd
Marysville, MI 48040-2121

Phone

(810) 364-4000

Fax

(810) 364-5995

NPI assigned

May 12, 2008

Sex

Female

Sole proprietor

No

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.

• Avalon Consultants PLLC

  • Family Medicine Physician
  • Novi, MI
  • NPI 1265859920
  Medicare reassignment MI
• Integrated Visiting Physician Solutions PC

  • Multi-Specialty Clinic/Center
  • Southfield, MI
  • NPI 1891109641
  Medicare reassignment MI
• Northwest Neurology PC

  • Neurology Physician
  • Southfield, MI
  • NPI 1467576132
  Medicare reassignment MI
• Complex Care Consultants LLC

  • Hospice and Palliative Medicine (Family Medicine) Physician
  • Novi, MI
  • NPI 1467076273
  NPD (past)
• Dial a Doc PC

  • Specialist
  • Waterford, MI
  • NPI 1891726212
  NPD (past)
• Farmington Associates

  • Ophthalmology Physician
  • Novi, MI
  • NPI 1962619759
  NPD (past)
• Home Medical Services PC

  • General Practice Physician
  • Detroit, MI
  • NPI 1407039076
  NPD (past)
• Ve Care, Inc

  • Home Health Agency
  • Pacifica, CA
  • NPI 1891262796
  NPD (past)

Medicare fee-for-service enrollment

Enrolled in MI

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.

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Oct 8, 2013.

{
    "created_epoch": "1210550400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1381190400000",
    "number": "1710154521",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3350 GRATIOT BLVD",
            "city": "MARYSVILLE",
            "state": "MI",
            "postal_code": "480402121",
            "telephone_number": "810-364-4000",
            "fax_number": "810-364-5995"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3350 GRATIOT BLVD",
            "city": "MARYSVILLE",
            "state": "MI",
            "postal_code": "480402121",
            "telephone_number": "810-364-4000",
            "fax_number": "810-364-5995"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCKISSICK",
        "first_name": "MARIANNE",
        "middle_name": "DOLORES",
        "name_prefix": "Mrs.",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-05-12",
        "last_updated": "2013-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601003532",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stephen J Maxfield
• Joyce J Maynard
• Jerry McClearen
• Norna J McConnell
• Rebecca Jo McFarlane
• McLane & Associates, P.C.
• Rodney David McLane, D.C.
• Julianna Noelle McMichael
• Courtney McMillan
• Meijer Inc

• All providers in Marysville, MI
• Physician Assistant in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2013; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.