Individual provider Active NPI

Marlea J Boyd, PA-C

  • Surgical Physician Assistant
  • Memphis, TN
National Provider Identifier
1851831234
Registry record updated Oct 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
4046 Issued in TN
Practice address
1325 Eastmoreland Ave Ste 310
Memphis, TN 38104-7544
Phone
(901) 758-7970
Fax
(901) 266-6425
NPI assigned
Mar 3, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X 4046 TN Primary

Addresses

Primary practice location

1325 Eastmoreland Ave Ste 310
Memphis, TN 38104-7544

Mailing address

PO Box 27892
Belfast, ME 04915-2030
Phone (901) 758-9900

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD, TN2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20170602000478 MD Practitioner - Physician Assistant 2769759349 Reassigns benefits to 1 organization
I20201119002340 TN Practitioner - Physician Assistant 2769759349 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
4046TNMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Capital Women'S Care, L.L.C. Current Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

61 Thomas Johnson Dr
Frederick, MD 21702
Phone (301) 663-6171

11850 W Market Pl
Ste P
Fulton, MD 20759

8110 Maple Lawn Blvd
Ste 235
Fulton, MD 20759

1165 Imperial Dr
Ste 300
Hagerstown, MD 21740
Phone (301) 665-9098

Interoperability endpoints

  • Direct secure messaging: mboyd30111@mlh.direct-ci.com

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": "1488499200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634860800000",
    "number": "1851831234",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 27892",
            "city": "BELFAST",
            "state": "ME",
            "postal_code": "049152030",
            "telephone_number": "901-758-9900",
            "fax_number": "901-752-2335"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1325 EASTMORELAND AVE STE 310",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381047544",
            "telephone_number": "901-758-7970",
            "fax_number": "901-266-6425"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOYD",
        "first_name": "MARLEA",
        "middle_name": "J",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-03-03",
        "last_updated": "2021-10-22",
        "certification_date": "2021-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "TN",
            "license": "4046",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Memphis, TN

Sources for this page

Verify at the official NPI Registry.