Individual provider Active NPI

Elizabeth A. Marlin, M.D.

  • Family Medicine Physician
  • Vienna, VA
National Provider Identifier
1740214071
Registry record updated Oct 10, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
010247693 Issued in VA
Practice address
100 Maple Ave E
Vienna, VA 22180-5723
Phone
(703) 938-5300
NPI assigned
Jul 11, 2006
Last updated
Oct 10, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 10, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 010247693 VA Primary

Addresses

Primary practice location

100 Maple Ave E
Vienna, VA 22180-5723

Mailing address

2616 Oakenshield Dr
Potomac, MD 20854-2928
Phone (301) 530-5623

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
010247693VAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
BC Missouri Emergency Physicians, LLP Past Accepting new patients
Emergency Physicians of St. Luke's, LLC Family Medicine Past Accepting new patients
Physician Specialists of St Lukes LLC Family Medicine Past Accepting new patients
BC Missouri Emergency Physicians, LLP PastSince Feb 22, 2005 Accepting new patients

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1152576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1349827200000",
    "number": "1740214071",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2616 OAKENSHIELD DR",
            "city": "POTOMAC",
            "state": "MD",
            "postal_code": "208542928",
            "telephone_number": "301-530-5623"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 MAPLE AVE E",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221805723",
            "telephone_number": "703-938-5300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARLIN",
        "first_name": "ELIZABETH",
        "middle_name": "A.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-11",
        "last_updated": "2012-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "VA",
            "license": "010247693",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vienna, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2012; 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.