Individual provider Active NPI

Marlee Kiefer

  • Family Nurse Practitioner
  • Evansville, IN
National Provider Identifier
1912551755
Registry record updated Jul 30, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
28211939A Issued in IN
Practice address
3801 Bellemeade Ave Ste 330
Evansville, IN 47714-0113
Phone
(812) 479-3125
NPI assigned
Jul 30, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 30, 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 28211939A IN Primary

Addresses

Primary practice location

3801 Bellemeade Ave Ste 330
Evansville, IN 47714-0113

Mailing address

PO Box 13059
Belfast, ME 04915-4021

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20191018001248 IN Practitioner - Nurse Practitioner 6709117922 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
28211939AINMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
St Mary's Medical Group, LLC Family CurrentSince Sep 8, 2019 Accepting new patients
St Mary's Medical Group, LLC CurrentSince Sep 8, 2019 Accepting new patients

Locations

801 Saint Marys Dr
Ste 505E
Evansville, IN 47714
Phone (812) 491-3236

3801 Bellemeade Ave
Ste 330
Evansville, IN 47714
Phone (812) 425-2646

Interoperability endpoints

  • Direct secure messaging: marlee.kiefer.1@7598.direct.athenahealth.com

Organizations & group practices 2

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": "1564444800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1564444800000",
    "number": "1912551755",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 13059",
            "city": "BELFAST",
            "state": "ME",
            "postal_code": "049154021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3801 BELLEMEADE AVE STE 330",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477140113",
            "telephone_number": "812-479-3125"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIEFER",
        "first_name": "MARLEE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-30",
        "last_updated": "2019-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "28211939A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Evansville, IN

Sources for this page

Verify at the official NPI Registry.