NPIMap

Individual provider Active NPI

Carol D Marsh, RN-CNP

  • Nurse Practitioner
  • Duluth, MN
National Provider Identifier
1750332177
Registry record updated Jan 25, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
R084357-1 Issued in MN
Practice address
1001 E Superior St
Ste, L201
Duluth, MN 55802-2207
Phone
(218) 249-3057
NPI assigned
May 12, 2006
Last updated
Jan 25, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X R084357-1 MN Primary

Addresses

Primary practice location

1001 E Superior St
Ste, L201
Duluth, MN 55802-2207

Mailing address

1001 E Superior St
Ste, L201
Duluth, MN 55802-2207
Phone (218) 249-3057

Other identifiers 2

IdentifierTypeStateIssuer
084917100MedicaidMN
500019351OtherMNMEDICARE RR

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address him@slk.direct.slhduluth.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN, WI2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20100122000446 MN Practitioner - Nurse Practitioner 4688716046 Reassigns benefits to 1 organization
I20150312001014 WI Practitioner - Nurse Practitioner 4688716046 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St. Luke's Hospital of DuluthGroup PAC ID 7113834839, shared by 9 NPIs, 409 clinicians

Practice addresses (Care Compare)

1001 E Superior St
Suite 201
Duluth, MN 55802-2228
Phone (218) 279-6230

1011 E 1St St
Duluth, MN 55805-2242
Phone (218) 249-7000

1015 E 1St St
Duluth, MN 55805-2242
Phone (218) 249-7860

2201 Lake Shore Dr E
Ashland, WI 54806-2331
Phone (715) 685-6600

915 E 1St St
Duluth, MN 55805-2107
Phone (218) 249-5439

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
R084357-1MNMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
St. Luke's Hospital of Duluth Current Accepting new patients
St. Luke's Hospital of Duluth CurrentSince Jun 1, 2001 Accepting new patients
St. Luke's Hospital of Duluth Current Accepting new patients
St. Luke's Hospital of Duluth Past Accepting new patients

Locations

29980 Network Pl
Chicago, IL 60673

1001 E Superior St
Ste L201
Duluth, MN 55802
Phone (218) 249-3057

1015 E 1st St
Duluth, MN 55805
Phone (218) 249-7860

915 E 1st St
Duluth, MN 55805
Phone (218) 249-5352

2201 Lake Shore Dr E
Ashland, WI 54806
Phone (715) 685-6600

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.

Hospital & facility affiliations 26

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 26

NPI Registry JSON

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

{
    "created_epoch": "1147392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611532800000",
    "number": "1750332177",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 E SUPERIOR ST",
            "address_2": "STE, L201",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558022207",
            "telephone_number": "218-249-3057"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 E SUPERIOR ST",
            "address_2": "STE, L201",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558022207",
            "telephone_number": "218-249-3057"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARSH",
        "first_name": "CAROL",
        "middle_name": "D",
        "name_prefix": "Ms.",
        "credential": "RN-CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-12",
        "last_updated": "2021-01-25",
        "certification_date": "2021-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MN",
            "license": "R084357-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "084917100",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RR",
            "identifier": "500019351",
            "state": "MN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "him@slk.direct.slhduluth.com",
            "affiliation": "N",
            "address_1": "1001 E Superior St",
            "address_2": "Ste, L201",
            "city": "Duluth",
            "state": "MN",
            "country_code": "US",
            "postal_code": "558022207",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Duluth, MN

Sources for this page

Verify at the official NPI Registry.