Marcus D Webb, FNP
Individual provider Active NPI Nurse Practitioner · Roan Mountain, TN
NPI 1952306359 · NPPES record last updated Jan 29, 2010
Key facts
- NPI
- 1952306359
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Nurse Practitioner 363L00000X
- License
- 100781 (TN)
- Practice address
- 152 Highway 143
Roan Mountain, TN 37687-3002 - Phone
- (423) 772-3276
- Fax
- (423) 772-4816
- NPI assigned
- Jun 14, 2005
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 3
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TN
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20081224000027 | TN | Practitioner - Nurse Practitioner | 5395807440 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 7010 | TN | MD | Professional Counselor |
| 100781 | TN | MD | Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Signify Health Medical Associates, PLLC | Nurse Practitioner | Current |
Accepting new patients |
| Fast Pace Medical Clinic PLLC | Current |
Accepting new patients | |
| Fast Pace Medical Clinic PLLC | Current |
Accepting new patients |
Locations
1874 Decatur Pike
Athens, TN 37303
Phone (423) 746-5973
300 Montvue Rd
Knoxville, TN 37919
Phone (818) 613-6769
931 Old Smithville Rd
McMinnville, TN 37110
Phone (931) 259-4144
4055 Valley View Ln
Ste 400
Dallas, TX 75244
Phone (469) 466-7037
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 100781 | TN | Yes |
Addresses
Primary practice location
152 Highway 143
Roan Mountain, TN 37687-3002
Mailing address
PO Box 850
Rogersville, TN 37857-0850
Phone (423) 772-3276
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3348529 | Medicaid | TN | |
| 4063399 | Other | TN | BCBST |
Other providers in Roan Mountain, TN
- Rural Health Services Consortium of Upper East Tennessee Inc
- Jennifer Lynn Hess Shuster
- Allison Marie Simerly
- The Waters of Roan Highlands LLC
- Janice H Tillman
- Rhonda Sue Whitehead
All providers in Roan Mountain, TN · Nurse Practitioner in Tennessee
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 29, 2010. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.