Individual provider Active NPI

Sheralyn Thompson Marble, R.N.

  • Registered Nurse
  • Clancy, MT
National Provider Identifier
1770817546
Registry record updated Sep 28, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
33978 Issued in MT
Practice address
10 Pinecone Draw
Clancy, MT 59634-9755
Phone
(406) 422-0390
NPI assigned
Sep 28, 2009
Last updated
Sep 28, 2009By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 28, 2009

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 33978 MT Primary
Registered Nurse 163W00000X 23509 WY

Addresses

Primary practice location

10 Pinecone Draw
Clancy, MT 59634-9755

Mailing address

10 Pinecone Draw
Clancy, MT 59634-9755
Phone (406) 422-0390

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)
Not enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
33978MTMDRegistered Nurse
23509WYMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1254096000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1254096000000",
    "number": "1770817546",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 PINECONE DRAW",
            "city": "CLANCY",
            "state": "MT",
            "postal_code": "596349755",
            "telephone_number": "406-422-0390"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 PINECONE DRAW",
            "city": "CLANCY",
            "state": "MT",
            "postal_code": "596349755",
            "telephone_number": "406-422-0390"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARBLE",
        "first_name": "SHERALYN",
        "middle_name": "THOMPSON",
        "credential": "R.N.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-09-28",
        "last_updated": "2009-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MT",
            "license": "33978",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WY",
            "license": "23509",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clancy, MT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2009; 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.