Active NPI
Marilyn Gribble Holland, APRN
- Family Nurse Practitioner
- Lake Charles, LA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- AP09148
- Practice address
- 2770 3Rd Ave Ste 110
Lake Charles, LA 70601-0404 - Phone
- (337) 494-4747
- Fax
- (337) 494-4773
- NPI assigned
- Mar 6, 2017
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | AP09148 | LA | Primary |
Addresses
Primary practice location
2770 3Rd Ave Ste 110
Lake Charles, LA 70601-0404
Mailing address
PO Box 122425 Dept 2425
Dallas, TX 75312-2425
Phone (337) 494-2921
Other practice location 1
2770 3rd Ave Ste 120
Lake Charles, LA 70601-8994
Phone (337) 494-4868
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| AP09148 | Other | LA | STATE LICENSE |
| 2441612 | Medicaid | LA |
Other names 1
- Marilyn Francis Gribble
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in LA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2016
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
2770 3Rd Ave
Suite 120
Lake Charles, LA 70601-8994
Phone (337) 494-4868
Hospital & facility affiliations
- Lake Charles Memorial Hospital
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| AP09148 | LA | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| LCMS Surgical Associates of Southwest Lousiana, LLC | Current | Accepting new patients |
Locations
2770 3rd Ave
Ste 110
Lake Charles, LA 70601
Phone (337) 494-2750
2770 3rd Ave
Ste 120
Lake Charles, LA 70601
Phone (337) 494-4868
Organizations & group practices 1
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.
-
- Surgery Physician
- Lake Charles, LA
- NPI 1407168032
Hospital & facility affiliations 3
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Gastroenterology Physician
- Lake Charles, LA
- NPI 1285351411
Hospital
-
- Rheumatology Physician
- Lake Charles, LA
- NPI 1659424075
Hospital
-
- General Acute Care Hospital
- Lake Charles, LA
- NPI 1972549855
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1488758400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1654732800000",
"number": "1861932154",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 122425 DEPT 2425",
"city": "DALLAS",
"state": "TX",
"postal_code": "753122425",
"telephone_number": "337-494-2921",
"fax_number": "337-494-6523"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2770 3RD AVE STE 110",
"city": "LAKE CHARLES",
"state": "LA",
"postal_code": "706010404",
"telephone_number": "337-494-4747",
"fax_number": "337-494-4773"
}
],
"practiceLocations": [
{
"address_1": "2770 3rd Ave Ste 120",
"address_purpose": "LOCATION",
"city": "Lake Charles",
"state": "LA",
"postal_code": "706018994",
"country_code": "US",
"telephone_number": "337-494-4868",
"fax_number": "337-494-4870",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "HOLLAND",
"first_name": "MARILYN",
"middle_name": "GRIBBLE",
"credential": "APRN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-03-06",
"last_updated": "2022-06-09",
"certification_date": "2022-06-09",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "LA",
"license": "AP09148",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE LICENSE",
"identifier": "AP09148",
"state": "LA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2441612",
"state": "LA"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "MARILYN",
"last_name": "GRIBBLE",
"middle_name": "FRANCIS",
"credential": "APRN",
"code": "1",
"type": "Former Name"
}
]
}
Other providers in Lake Charles, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.