Individual provider Active NPI

Marisa Leigh Parker, ANP-BC, CVNP-BC

  • Adult Health Nurse Practitioner
  • Webster, TX
National Provider Identifier
1962789651
Registry record updated May 3, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
16245 Issued in TN
Practice address
450 Blossom St Ste D
Webster, TX 77598-4200
Phone
(832) 905-5940
NPI assigned
Nov 8, 2011
Last updated
May 3, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 3, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 1068733 TX
Adult Health Nurse Practitioner 363LA2200X 16245 TN Primary

Addresses

Primary practice location

450 Blossom St Ste D
Webster, TX 77598-4200

Mailing address

450 Blossom St Ste D
Webster, TX 77598-4200
Phone (832) 905-5940

Other practice location 1

2305 Chambliss Ave NW
Cleveland, TN 37311-3847
Phone (423) 559-6583

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address marissa.burns.1@1525.direct.athenahealth.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, GA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20220514000204 TX Practitioner - Nurse Practitioner 1850567272 Reassigns benefits to 1 organization
I20240319001021 GA Practitioner - Nurse Practitioner 1850567272 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Vanderbilt University School of Medicine, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Central Georgia Heart Center, PCGroup PAC ID 0446248736, 27 clinicians

Practice addresses (Care Compare)

304 Margie Dr
Warner Robins, GA 31088-7817
Phone (478) 741-1208

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
16245TNMDMedical Oncology Physician
1068733TXMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
CPF Cardiology Associates, P.a. CurrentSince Oct 16, 2023 Accepting new patients
Central Georgia Heart Center, PC CurrentSince Mar 11, 2024 Accepting new patients
Central Georgia Heart Center, PC CurrentSince Mar 11, 2024 Accepting new patients

Locations

1062 Forsyth St
Ste 1B
Macon, GA 31201
Phone (912) 743-7068

2960 Riverside Dr
Macon, GA 31204

750 N Cobb St
Ste 130
Milledgeville, GA 31061
Phone (478) 452-1024

750 N Cobb St
Ste 150
Milledgeville, GA 31061
Phone (478) 284-0670

304 Margie Dr
Warner Robins, GA 31088
Phone (478) 333-2965

6807 Emmett F Lowry Expy
Ste 302D
Texas City, TX 77591
Phone (832) 905-5940

450 Blossom St
Ste D
Webster, TX 77598
Phone (832) 905-4044

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/GGEADD
  • Direct secure messaging: marissa.burns.1@1525.direct.athenahealth.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1320710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651536000000",
    "number": "1962789651",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "450 BLOSSOM ST STE D",
            "city": "WEBSTER",
            "state": "TX",
            "postal_code": "775984200",
            "telephone_number": "832-905-5940"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "450 BLOSSOM ST STE D",
            "city": "WEBSTER",
            "state": "TX",
            "postal_code": "775984200",
            "telephone_number": "832-905-5940"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2305 Chambliss Ave NW",
            "address_purpose": "LOCATION",
            "city": "Cleveland",
            "state": "TN",
            "postal_code": "373113847",
            "country_code": "US",
            "telephone_number": "423-559-6583",
            "fax_number": "423-559-6867",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PARKER",
        "first_name": "MARISA",
        "middle_name": "LEIGH",
        "name_prefix": "Mrs.",
        "credential": "ANP-BC, CVNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-11-08",
        "last_updated": "2022-05-03",
        "certification_date": "2022-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "TX",
            "license": "1068733",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "TN",
            "license": "16245",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "marissa.burns.1@1525.direct.athenahealth.com",
            "affiliation": "N",
            "endpointDescription": "AMR Direct Address",
            "address_1": "2305 Chambliss Ave NW",
            "city": "Cleveland",
            "state": "TN",
            "country_code": "US",
            "postal_code": "373113847",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Webster, TX

Sources for this page

Verify at the official NPI Registry.