Individual provider Active NPI

John D Marino, FNP

  • Family Nurse Practitioner
  • Denham Springs, LA
National Provider Identifier
1962647610
Registry record updated Nov 16, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
05610 APRN Issued in LA
Practice address
1585 S Range Ave
Denham Springs, LA 70726-5201
Phone
(225) 791-0002
NPI assigned
Dec 10, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 16, 2011

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 05610 APRN LA Primary
Family Nurse Practitioner 363LF0000X 100696 RN LA

Addresses

Primary practice location

1585 S Range Ave
Denham Springs, LA 70726-5201

Mailing address

Dept 960139
Oklahoma City, OK 73196-0139
Phone (877) 485-4474

Other identifiers 2

IdentifierTypeStateIssuer
1799190MedicaidLA
P00913286OtherLARRMCARE THRU DSUC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
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
I20090611000401 LA Practitioner - Nurse Practitioner 8820148935 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Convenient Care LLCGroup PAC ID 1153306816, 36 clinicians

Practice addresses (Care Compare)

12525 Perkins Rd
Suite B
Baton Rouge, LA 70810-1907
Phone (225) 819-8857

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
05610 APRNLAMDFamily Nurse Practitioner
100696 RNLAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Convenient Care LLC Current Accepting new patients
Convenient Care LLC CurrentSince Mar 24, 2016 Accepting new patients
Convenient Care LLC CurrentSince Mar 24, 2016 Accepting new patients

Locations

12525 Perkins Rd
#B
Baton Rouge, LA 70810
Phone (225) 819-8857

10319 Jefferson Hwy
Baton Rouge, LA 70809
Phone (224) 214-9352

8249 Vincent Rd
Denham Springs, LA 70726
Phone (225) 480-1210

Organizations & group practices 3

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": "1228867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1321401600000",
    "number": "1962647610",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "DEPT 960139",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731960139",
            "telephone_number": "877-485-4474"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1585 S RANGE AVE",
            "city": "DENHAM SPRINGS",
            "state": "LA",
            "postal_code": "707265201",
            "telephone_number": "225-791-0002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARINO",
        "first_name": "JOHN",
        "middle_name": "D",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-12-10",
        "last_updated": "2011-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "LA",
            "license": "05610 APRN",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "LA",
            "license": "100696 RN",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1799190",
            "state": "LA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RRMCARE THRU DSUC",
            "identifier": "P00913286",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Denham Springs, LA

Sources for this page

Verify at the official NPI Registry.