Marissa Anne Fortuna, MSN, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

A166951 Issued in IA

Practice address

1850 E 53Rd St Ste 2
Davenport, IA 52807-2784

Phone

(563) 335-9410

NPI assigned

Oct 31, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Marissa Stafford Former name

Medicare fee-for-service enrollment

Enrolled in IA

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

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science - Nursing

State licenses

Practice roles

Locations

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.

• Quad City Family Physicians, PC

  • General Practice Physician
  • Davenport, IA
  • NPI 1265430961
  Medicare reassignment
• Ideal Health and Wellness, SC

  • Family Medicine Physician
  • Davenport, IA
  • NPI 1689013393
  NPD

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

{
    "created_epoch": "1667174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706140800000",
    "number": "1891402830",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1850 E 53RD ST STE 2",
            "city": "DAVENPORT",
            "state": "IA",
            "postal_code": "528072784",
            "telephone_number": "563-359-4106"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1850 E 53RD ST STE 2",
            "city": "DAVENPORT",
            "state": "IA",
            "postal_code": "528072784",
            "telephone_number": "563-335-9410"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FORTUNA",
        "first_name": "MARISSA",
        "middle_name": "ANNE",
        "credential": "MSN, FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-10-31",
        "last_updated": "2024-01-25",
        "certification_date": "2024-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IA",
            "license": "A166951",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARISSA",
            "last_name": "STAFFORD",
            "credential": "MSN, FNP-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Monica Foley, DDS
• Dailen Marie Folkedahl, DO
• Foot First Podiatry Centers, V.P.C.
• Barbara Jane Ford, RN
• Blair W Foreman, M.D.
• Danielle Foster
• Claire Elizabeth Fourdyce, NP-C
• Adrienne Marie Fouts, MD
• Renee M Fox, PHARMD
• Sarah Rose Fox, DPT

• Family Nurse Practitioner in Davenport, IA
• Providers in Davenport, IA by specialty
• Family Nurse Practitioner in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2024; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.