Individual provider Active NPI

Adrienne Vanleer Ada Marsh, NP

  • Family Nurse Practitioner
  • Carson, CA
National Provider Identifier
1891343505
Registry record updated Aug 27, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95010379 Issued in CA
Practice address
1000 E Dominguez St
Carson, CA 90746-3600
Phone
(310) 715-7755
NPI assigned
Aug 27, 2019
Last updated
Aug 27, 2019By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 27, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 95010379 CA Primary

Addresses

Primary practice location

1000 E Dominguez St
Carson, CA 90746-3600

Mailing address

1407 Brett PL Apt 102
San Pedro, CA 90732-5044
Phone (310) 283-5794

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20200122000565 CA Practitioner - Nurse Practitioner 3577998566 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Richard M Butlig M D IncGroup PAC ID 1254472525, 8 clinicians

Practice addresses (Care Compare)

1727 Crenshaw Blvd
Torrance, CA 90501-3312
Phone (310) 373-7855

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
95010379CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Richard M Butlig MD Inc CurrentSince Nov 2, 2019 Accepting new patients

Locations

1727 Crenshaw Blvd
Torrance, CA 90501
Phone (310) 373-7855

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1566864000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566864000000",
    "number": "1891343505",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1407 BRETT PL APT 102",
            "city": "SAN PEDRO",
            "state": "CA",
            "postal_code": "907325044",
            "telephone_number": "310-283-5794"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 E DOMINGUEZ ST",
            "city": "CARSON",
            "state": "CA",
            "postal_code": "907463600",
            "telephone_number": "310-715-7755"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARSH",
        "first_name": "ADRIENNE",
        "middle_name": "VANLEER ADA",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-08-27",
        "last_updated": "2019-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95010379",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Carson, CA

Sources for this page

Verify at the official NPI Registry.