Individual provider Active NPI

Marisa Lapp

  • Nurse Practitioner
  • Fort Wayne, IN
National Provider Identifier
1871152439
Registry record updated Aug 30, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
71009288A Issued in IN
Practice address
1818 Carew St Ste 120
Fort Wayne, IN 46805-4764
Phone
(260) 425-6200
NPI assigned
Jun 7, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 30, 2019

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 28195650A IN
Nurse Practitioner 363L00000X 71009288A IN Primary

Addresses

Primary practice location

1818 Carew St Ste 120
Fort Wayne, IN 46805-4764

Mailing address

3702 New Vision Dr BLDG B
Fort Wayne, IN 46845-1703

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20250331002608 TX Practitioner - Nurse Practitioner 5991035511 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
28195650AINMDRegistered Nurse

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.

NPI Registry JSON

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

{
    "created_epoch": "1559865600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1567123200000",
    "number": "1871152439",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3702 NEW VISION DR BLDG B",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468451703"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1818 CAREW ST STE 120",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468054764",
            "telephone_number": "260-425-6200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAPP",
        "first_name": "MARISA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-07",
        "last_updated": "2019-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IN",
            "license": "28195650A",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IN",
            "license": "71009288A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Wayne, IN

Sources for this page

Verify at the official NPI Registry.