Active NPI
Marina Fedotowsky, CFNP
- Family Nurse Practitioner
- Deming, NM
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- APRN.CNP.020037
- Practice address
- 1511 S Lime St
Deming, NM 88030-6207 - Phone
- (575) 538-2981
- NPI assigned
- Feb 8, 2017
- Last updated
- Oct 26, 2022
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | APRN.CNP.020037 | OH | Primary |
| Primary Care Nurse Practitioner | 363LP2300X | 54159 | NM |
Addresses
Primary practice location
1511 S Lime St
Deming, NM 88030-6207
Mailing address
1600 E 32ND St
Silver City, NM 88061-7287
Phone (575) 538-2981
Other practice location 1
905 S 8th St Ste B
Deming, NM 88030-4037
Phone (575) 543-7200 ext. 4224
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NM
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2016
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
111 N Pearl St
Deming, NM 88030-3835
Phone (575) 517-2725
1600 E 32ND St
Silver City, NM 88061-7287
Phone (575) 538-2981
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 54159 | NM | MD | Primary Care Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Deming Hospital Corporation | Current | Accepting new patients | |
| Deming Hospital Corporation | Current | Accepting new patients | |
| Deming Hospital Corporation | Current | Accepting new patients | |
| Summits Healthcare, LLC | Family | Current | Accepting new patients |
Locations
111 N Pearl St
Deming, NM 88030
Phone (575) 517-2725
722 E Florida St
Deming, NM 88030
Phone (505) 546-2555
905 S 8th St
Deming, NM 88030
Phone (575) 543-7200
905 S 8th St
Ste B
Deming, NM 88030
Phone (575) 543-7200
Interoperability endpoints
- fedotowm@yourcarecommunity.org
- marina.fedotowsky.1@20156.direct.athenahealth.com
Organizations & group practices 5
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.
-
- Internal Medicine Physician
- Silver City, NM
- NPI 1548291586
-
dba Mimbres Valley Medical Group
- Rural Health Clinic/Center
- Deming, NM
- NPI 1134526221
-
dba Mimbres Memorial Hosp - Anest & Pain Mgt
- Pain Medicine (Anesthesiology) Physician
- Deming, NM
- NPI 1386850519
-
dba Mimbres Memorial Hospital
- Medicare Defined Swing Bed Hospital Unit
- Deming, NM
- NPI 1710196571
Hospital & facility affiliations 3
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Mimbres Memorial Hospital
- Critical Access Hospital
- Deming, NM
- NPI 1891075446
-
dba Memorial Medical Center of Las Cruces
- General Acute Care Hospital
- Las Cruces, NM
- NPI 1700821808
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1486512000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1666742400000",
"number": "1942748017",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1600 E 32ND ST",
"city": "SILVER CITY",
"state": "NM",
"postal_code": "880617287",
"telephone_number": "575-538-2981"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1511 S LIME ST",
"city": "DEMING",
"state": "NM",
"postal_code": "880306207",
"telephone_number": "575-538-2981"
}
],
"practiceLocations": [
{
"address_1": "905 S 8th St Ste B",
"address_purpose": "LOCATION",
"city": "Deming",
"state": "NM",
"postal_code": "880304037",
"country_code": "US",
"telephone_number": "575-543-7200 x4224",
"fax_number": "575-543-6961",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "FEDOTOWSKY",
"first_name": "MARINA",
"credential": "CFNP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-02-08",
"last_updated": "2022-10-26",
"certification_date": "2021-03-01",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "OH",
"license": "APRN.CNP.020037",
"primary": true
},
{
"code": "363LP2300X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Primary Care",
"state": "NM",
"license": "54159",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Deming, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2022; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.