Individual provider Active NPI

Marnie Predovich, NP

  • Acute Care Nurse Practitioner
  • Denver, CO
National Provider Identifier
1790358182
Registry record updated Jun 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
APN.0998331-NP Issued in CO
Practice address
1441 Little Raven St
Denver, CO 80202-6427
Phone
(303) 900-8582
NPI assigned
Jul 22, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 28, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 2000281875 CO
Acute Care Nurse Practitioner 363LA2100X APN.0998331-NP CO Primary

Addresses

Primary practice location

1441 Little Raven St
Denver, CO 80202-6427

Mailing address

3680 N State Highway 67
Sedalia, CO 80135-8959

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
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
I20230216002612 CO Practitioner - Nurse Practitioner 8123490323 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Goodness Health, LLCGroup PAC ID 1850694985, 61 clinicians

Practice addresses (Care Compare)

925 N Lincoln St
Apt 15a
Denver, CO 80203-2768
Phone (720) 500-5488

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
2000281875COMDAcute Care Nurse Practitioner
APN.0998331-NPCOMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Goodness Health, LLC CurrentSince Jan 2, 2023 Accepting new patients
Goodness Health, LLC CurrentSince Jan 2, 2023 Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1626912000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687910400000",
    "number": "1790358182",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3680 N STATE HIGHWAY 67",
            "city": "SEDALIA",
            "state": "CO",
            "postal_code": "801358959"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1441 LITTLE RAVEN ST",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802026427",
            "telephone_number": "303-900-8582"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PREDOVICH",
        "first_name": "MARNIE",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-07-22",
        "last_updated": "2023-06-28",
        "certification_date": "2023-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "CO",
            "license": "2000281875",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "CO",
            "license": "APN.0998331-NP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Denver, CO

Sources for this page

Verify at the official NPI Registry.