Individual provider Active NPI

Christina Marie Marryott, FNP

  • Family Nurse Practitioner
  • Syracuse, NY
National Provider Identifier
1811483183
Registry record updated Aug 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F-343045-1 Issued in NY
Practice address
1000 E Genesee St Ste 300
Syracuse, NY 13210-1851
Phone
(315) 471-1044
NPI assigned
Jul 10, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 1, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X F-343045-1 NY Primary

Addresses

Primary practice location

1000 E Genesee St Ste 300
Syracuse, NY 13210-1851

Mailing address

1000 E Genesee St Ste 300
Syracuse, NY 13210-1851
Phone (315) 471-1044

Other identifiers 1

IdentifierTypeStateIssuer
05317717MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20181218003066 NY Practitioner - Nurse Practitioner 1153666276 Reassigns benefits to 4 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
F-343045-1NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
NV Pacs 2 LLC CurrentSince May 13, 2024 Accepting new patients
New York General Medical Services PC CurrentSince May 13, 2024 Accepting new patients
St Josephs Medical PC CurrentSince Nov 10, 2018 Accepting new patients
CS Pacs 3 Northeast, LLC CurrentSince Nov 10, 2024 Accepting new patients
North Medical PC Current Accepting new patients

Locations

6221 State Route 31
Cicero, NY 13039
Phone (315) 752-0100

6411 Beach Channel Dr
Far Rockaway, NY 11692
Phone (718) 471-7010

4241 201st St
Flushing, NY 11361
Phone (516) 599-5688

5100 W Taft Rd
Ste 2T
Liverpool, NY 13088
Phone (315) 744-1592

2090 Albany Post Rd
Montrose, NY 10548
Phone (914) 788-6003

321 Genesee St
Oneida, NY 13421
Phone (315) 361-2020

17850 Linden Blvd
Rochdale Village, NY 11434
Phone (718) 990-0300

1 Elsie St
Rome, NY 13440
Phone (315) 336-4435

1000 E Genesee St
Ste 300
Syracuse, NY 13210
Phone (315) 471-1044

301 Prospect Ave
Syracuse, NY 13203
Phone (315) 448-5111

100 Lake Rd
Vly Cottage, NY 10989
Phone (845) 268-6813

Interoperability endpoints

  • Direct secure messaging: cwright2386846@direct.trinity-health.org

Organizations & group practices 5

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": "1531180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690848000000",
    "number": "1811483183",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 E GENESEE ST STE 300",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132101851",
            "telephone_number": "315-471-1044"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 E GENESEE ST STE 300",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132101851",
            "telephone_number": "315-471-1044"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARRYOTT",
        "first_name": "CHRISTINA",
        "middle_name": "MARIE",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-10",
        "last_updated": "2023-08-01",
        "certification_date": "2023-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "F-343045-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "05317717",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Syracuse, NY

Sources for this page

Verify at the official NPI Registry.