Individual provider Active NPI

Marissa L Parrish, APRN

  • Gerontology Nurse Practitioner
  • Clearwater, FL
National Provider Identifier
1861186389
Registry record updated Jun 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
11026778 Issued in FL
Practice address
508 Jeffords St Ste D
Clearwater, FL 33756-3839
Phone
(727) 443-7700
NPI assigned
Jun 7, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 19, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X 11026778 FL Primary

Addresses

Primary practice location

508 Jeffords St Ste D
Clearwater, FL 33756-3839

Mailing address

3001 Executive Dr Ste 130
Clearwater, FL 33762-5323
Phone (727) 347-0005

Other practice location 1

646 Virginia St Fl 2
Dunedin, FL 34698-6612
Phone (727) 443-7700

Other names 1

  • Marissa L Hodgson Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20230713003261 FL Practitioner - Nurse Practitioner 1153781737 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sage Infusion, LLCGroup PAC ID 1254660467, 44 clinicians

Practice addresses (Care Compare)

4728 N Habana Ave
Suite 101B
Tampa, FL 33614-7149
Phone (813) 775-9997

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
11026778FLMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Sage Infusion, LLC CurrentSince Dec 13, 2024 Accepting new patients
West Central Gastroenterology LLP CurrentSince Jun 26, 2023 Accepting new patients
Gastro Florida Pharmacy, LLC CurrentSince Jun 23, 2024 Accepting new patients
Gastroenterology Consultants of Clearwater PastSince Jun 11, 2023 Accepting new patients

Locations

508 Jeffords St
Ste D
Clearwater, FL 33756
Phone (727) 442-4188

3001 Executive Dr
Ste 130
Clearwater, FL 33762
Phone (727) 329-3371

646 Virginia St
Fl 2
Dunedin, FL 34698
Phone (727) 443-7700

8880 Gladiolus Dr
Ste C200
Fort Myers, FL 33908
Phone (239) 533-5962

1090 NW 8th Ave
Ste 30
Gainesville, FL 32601
Phone (352) 450-8886

3200 SW 34th Ave
Ste 502
Ocala, FL 34474
Phone (352) 237-7355

6225 66th St N
Pinellas Park, FL 33781
Phone (727) 521-0994

2191 9th Ave N
Ste 105
St Petersburg, FL 33713
Phone (727) 209-1419

4728 N Habana Ave
Tampa, FL 33614
Phone (813) 343-0400

4728 N Habana Ave
Ste 101B
Tampa, FL 33614
Phone (813) 775-9997

910 Old Camp Rd
Ste 196
The Villages, FL 32162
Phone (352) 565-5553

2789 Brownwood Blvd
The Villages, FL 32163
Phone (352) 450-3080

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

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": "1686096000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718755200000",
    "number": "1861186389",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3001 EXECUTIVE DR STE 130",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337625323",
            "telephone_number": "727-347-0005",
            "fax_number": "727-541-6558"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "508 JEFFORDS ST STE D",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337563839",
            "telephone_number": "727-443-7700"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "646 Virginia St Fl 2",
            "address_purpose": "LOCATION",
            "city": "Dunedin",
            "state": "FL",
            "postal_code": "346986612",
            "country_code": "US",
            "telephone_number": "727-443-7700",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PARRISH",
        "first_name": "MARISSA",
        "middle_name": "L",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-06-07",
        "last_updated": "2024-06-19",
        "certification_date": "2024-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "FL",
            "license": "11026778",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARISSA",
            "last_name": "HODGSON",
            "middle_name": "L",
            "credential": "APRN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Clearwater, FL

Sources for this page

Verify at the official NPI Registry.