Individual provider Active NPI

Marianne Kathryn Debarbadillo, BC-FNP

  • Family Nurse Practitioner
  • Huntington, WV
National Provider Identifier
1902921372
Registry record updated Feb 28, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
35013 Issued in WV
Practice address
5933 E Pea Ridge Rd
Huntington, WV 25705-2629
Phone
(304) 736-6262
Fax
(304) 736-5984
NPI assigned
Mar 21, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 28, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X NP-00372 OH
Family Nurse Practitioner 363LF0000X 35013 WV Primary

Addresses

Primary practice location

5933 E Pea Ridge Rd
Huntington, WV 25705-2629

Mailing address

804 Water St # a
Barboursville, WV 25504-1929
Phone (304) 733-2930

Other identifiers 1

IdentifierTypeStateIssuer
2085792MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
00372OHMDAthletic Trainer
NP-00372OHMDFamily Nurse Practitioner
35013WVMDFamily Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1174435200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1488240000000",
    "number": "1902921372",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "804 WATER ST # A",
            "city": "BARBOURSVILLE",
            "state": "WV",
            "postal_code": "255041929",
            "telephone_number": "304-733-2930",
            "fax_number": "304-736-5984"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5933 E PEA RIDGE RD",
            "city": "HUNTINGTON",
            "state": "WV",
            "postal_code": "257052629",
            "telephone_number": "304-736-6262",
            "fax_number": "304-736-5984"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEBARBADILLO",
        "first_name": "MARIANNE",
        "middle_name": "KATHRYN",
        "name_prefix": "Mrs.",
        "credential": "BC-FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-21",
        "last_updated": "2017-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "NP-00372",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WV",
            "license": "35013",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2085792",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Huntington, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2017; 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.