Individual provider Active NPI

Marie Louis, ADMINISTRATOR

  • Nursing Home Administrator
  • Palm Coast, FL
National Provider Identifier
1992157689
Registry record updated Jul 6, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nursing Home AdministratorTaxonomy code 376G00000X
License
6906826 Issued in FL
Practice address
19 Burning Wick PL
Palm Coast, FL 32137-8802
Phone
(386) 631-0432
NPI assigned
Jul 6, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 6, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nursing Home Administrator 376G00000X 6906826 FL Primary

Addresses

Primary practice location

19 Burning Wick PL
Palm Coast, FL 32137-8802

Mailing address

19 Burning Wick PL
Palm Coast, FL 32137-8802
Phone (386) 631-0432

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
6906826FLMDNursing Home Administrator

Practice roles

OrganizationSpecialtyStatusNew patients
One Family Home Health Care Past Accepting new patients

Organizations & group practices 1

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": "1467763200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1467763200000",
    "number": "1992157689",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19 BURNING WICK PL",
            "city": "PALM COAST",
            "state": "FL",
            "postal_code": "321378802",
            "telephone_number": "386-631-0432"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19 BURNING WICK PL",
            "city": "PALM COAST",
            "state": "FL",
            "postal_code": "321378802",
            "telephone_number": "386-631-0432"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOUIS",
        "first_name": "MARIE",
        "name_prefix": "Ms.",
        "credential": "ADMINISTRATOR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-07-06",
        "last_updated": "2016-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "376G00000X",
            "taxonomy_group": "",
            "desc": "Nursing Home Administrator",
            "state": "FL",
            "license": "6906826",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palm Coast, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.