Michele Ann Marks, NURSE PRACTITIONER

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

520412 Issued in CA

Practice address

18425 Burbank Blvd
Suite 719
Tarzana, CA 91356

Phone

(818) 342-0793

NPI assigned

Jun 27, 2013

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Hospital Pediatric Specialists Medical Group, Inc

  • Pediatrics Physician
  • Tarzana, CA
  • NPI 1720273683
  NPD (past)

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

{
    "created_epoch": "1372291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1372291200000",
    "number": "1891135596",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18425 BURBANK BLVD",
            "address_2": "SUITE 719",
            "city": "TARZANA",
            "state": "CA",
            "postal_code": "91356",
            "telephone_number": "818-342-0793"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18425 BURBANK BLVD",
            "address_2": "SUITE 719",
            "city": "TARZANA",
            "state": "CA",
            "postal_code": "91356",
            "telephone_number": "818-342-0793"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARKS",
        "first_name": "MICHELE",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-06-27",
        "last_updated": "2013-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "CA",
            "license": "520412",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Natalie Marin, MS
• Adriana Elizabeth Mariscal
• Mark Fisher DDS Professional Dental Corporation
• Mark John Souris
• Lisa Markinson, M.F.T.
• Richard Allen Marquez
• Samuel Marroquin
• Marshall R. Lapin D.D.S. Inc.
• Pamela Marshall, CDC
• Marsham Medical

• All providers in Tarzana, CA
• Pediatric Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.