Individual provider Active NPI

Charisse Marks, DNP

  • Family Nurse Practitioner
  • Camp Hill, PA
National Provider Identifier
1831706498
Registry record updated Jun 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
SP026590 Issued in PA
Practice address
503 N 21St St
Camp Hill, PA 17011-2204
Phone
(717) 763-2100
NPI assigned
Sep 28, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 19, 2023

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 RN179595 AZ
Family Nurse Practitioner 363LF0000X SP026590 PA Primary

Addresses

Primary practice location

503 N 21St St
Camp Hill, PA 17011-2204

Mailing address

1954 Reservoir Dr
Carlisle, PA 17013-1055
Phone (520) 508-0335

Other practice location 1

2200 Good Hope Rd
Enola, PA 17025-1210
Phone (717) 981-9000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20230801002264 PA Practitioner - Nurse Practitioner 3779944111 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
Group practices
Penn State Health Medical Group LLCGroup PAC ID 8729351077, 720 clinicians

Practice addresses (Care Compare)

503 N 21St St
Camp Hill, PA 17011-2204
Phone (717) 234-2561

Merit-based Incentive Payment System (MIPS)

Final score
82.85 of 100Reported as group
Quality
65.84
Promoting interoperability
100
Improvement activities
40
Cost
77

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN179595AZMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Penn State Health Medical Group, LLC CurrentSince Aug 14, 2023 Accepting new patients
Penn State Health Medical Group, LLC CurrentSince Aug 14, 2023 Accepting new patients
Penn State Health Medical Group, LLC Current Accepting new patients
Penn State Health Medical Group, LLC Past Accepting new patients

Locations

503 N 21st St
Camp Hill, PA 17011
Phone (717) 763-2100

429 N 21st St
Camp Hill, PA 17011
Phone (717) 761-7244

2200 Good Hope Rd
Enola, PA 17025
Phone (717) 981-8230

1120 Cocoa Ave
Hershey, PA 17033
Phone (717) 533-4141

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1601251200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687132800000",
    "number": "1831706498",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1954 RESERVOIR DR",
            "city": "CARLISLE",
            "state": "PA",
            "postal_code": "170131055",
            "telephone_number": "520-508-0335"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "503 N 21ST ST",
            "city": "CAMP HILL",
            "state": "PA",
            "postal_code": "170112204",
            "telephone_number": "717-763-2100"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2200 Good Hope Rd",
            "address_purpose": "LOCATION",
            "city": "Enola",
            "state": "PA",
            "postal_code": "170251210",
            "country_code": "US",
            "telephone_number": "717-981-9000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MARKS",
        "first_name": "CHARISSE",
        "name_prefix": "Dr.",
        "credential": "DNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-09-28",
        "last_updated": "2023-06-19",
        "certification_date": "2023-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "AZ",
            "license": "RN179595",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "PA",
            "license": "SP026590",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Camp Hill, PA

Sources for this page

Verify at the official NPI Registry.