Active NPI
Jacqueline Marks, NP
- Primary Care Nurse Practitioner
- Canton, GA
National Provider Identifier
1942634175
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Primary Care Nurse Practitioner
- License
- RN163623
- Practice address
- 450 Northside Cherokee Blvd
Canton, GA 30115-8015 - Phone
- (770) 224-1000
- Fax
- (770) 224-2451
- NPI assigned
- Aug 23, 2013
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Primary Care Nurse Practitioner | 363LP2300X | RN163623 | GA | Primary |
| Family Nurse Practitioner | 363LF0000X | AP124180 | TX | |
| Primary Care Nurse Practitioner | 363LP2300X | 840805 | TX |
Addresses
Primary practice location
450 Northside Cherokee Blvd
Canton, GA 30115-8015
Mailing address
7703 Floyd Curl Dr
Mc7977
San Antonio, TX 78229-3901
Phone (210) 358-4000
Other practice location 1
16755 Huebner Rd
San Antonio, TX 78248-2342
Phone (210) 493-4357
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 327389802 | Medicaid | TX | |
| 327389803 | Other | TX | CSHCN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Certified Nurse Practitioner, Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 840805 | TX | MD | Primary Care Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Vitas Health Services of Texas, P.a. | Current | Accepting new patients | |
| Curana Health Medical Group LLC | Current | Accepting new patients |
Locations
9903 Hunters Pond
San Antonio, TX 78224
Phone (210) 477-2200
8401 Datapoint Dr
Ste 300
San Antonio, TX 78229
Phone (210) 348-4040
Interoperability endpoints
- https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
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.
-
- Internal Medicine Physician
- Austin, TX
- NPI 1255640678
-
- Hospice and Palliative Medicine (Internal Medicine) Physician
- Dallas, TX
- NPI 1740566017
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1377216000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783382400000",
"number": "1942634175",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7703 FLOYD CURL DR",
"address_2": "MC7977",
"city": "SAN ANTONIO",
"state": "TX",
"postal_code": "782293901",
"telephone_number": "210-358-4000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "450 NORTHSIDE CHEROKEE BLVD",
"city": "CANTON",
"state": "GA",
"postal_code": "301158015",
"telephone_number": "770-224-1000",
"fax_number": "770-224-2451"
}
],
"practiceLocations": [
{
"address_1": "16755 Huebner Rd",
"address_purpose": "LOCATION",
"city": "San Antonio",
"state": "TX",
"postal_code": "782482342",
"country_code": "US",
"telephone_number": "210-493-4357",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MARKS",
"first_name": "JACQUELINE",
"name_prefix": "Mrs.",
"credential": "NP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-08-23",
"last_updated": "2026-07-07",
"certification_date": "2026-07-07",
"status": "A"
},
"taxonomies": [
{
"code": "363LP2300X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Primary Care",
"state": "GA",
"license": "RN163623",
"primary": true
},
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "TX",
"license": "AP124180",
"primary": false
},
{
"code": "363LP2300X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Primary Care",
"state": "TX",
"license": "840805",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "327389802",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CSHCN",
"identifier": "327389803",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Canton, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2026; 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.