Marissa Ann Kuykendall, CNM

Primary specialty

Advanced Practice MidwifeTaxonomy code 367A00000X

License

AP143178 Issued in TX

Practice address

928 N Glenwood Blvd
Tyler, TX 75702-5055

Phone

(903) 535-9041

NPI assigned

Sep 25, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Miss Marissa Cannon Former name

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Certified Nurse Midwife (CNM)

Education

Texas Tech University Health Science Center School of Medicine, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Tyler Obstetrics and Gynecology L L PGroup PAC ID 3173594645, 5 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Midwife

State licenses

Practice roles

Locations

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.

• Tyler Obstetrics and Gynecology L L P

  • Obstetrics & Gynecology Physician
  • Tyler, TX
  • NPI 1265493266
  Medicare reassignment Care Compare group NPD
• Longview Wellness Center, Inc

  • Federally Qualified Health Center (FQHC)
  • Longview, TX
  • NPI 1942269493
  Medicare reassignment NPD
• Obhg Texas Holdings, P.a.

  • Obstetrics & Gynecology Physician
  • Austin, TX
  • NPI 1083917769
  Medicare reassignment NPD
• University of Texas Southwestern Medical Center at Dallas

  • Anesthesiology Physician
  • Dallas, TX
  • NPI 1942270566
  Medicare reassignment NPD
• Longview Wellness Center Inc

  • Federally Qualified Health Center (FQHC)
  • Longview, TX
  • NPI 1255137659
  NPD
• Longview Wellness Center Inc

  • Federally Qualified Health Center (FQHC)
  • Longview, TX
  • NPI 1962911149
  NPD
• The University of Texas Southwestern Medical Center at Dallas

  • Clinical Medical Laboratory
  • Dallas, TX
  • NPI 1396832713
  NPD
• University of Texas Southwestern Medical Center at Dallas

  • Obstetrics & Gynecology Physician
  • Dallas, TX
  • NPI 1710959135
  NPD
• Longview Wellness Center Inc

  • Federally Qualified Health Center (FQHC)
  • Longview, TX
  • NPI 1447910542
  NPD (past)
• Tyler Family Circle of Care

  • Community/Retail Pharmacy
  • Tyler, TX
  • NPI 1942011903
  NPD (past)

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

{
    "created_epoch": "1569369600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698624000000",
    "number": "1992356588",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5323 HARRY HINES BLVD",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753909032"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "928 N GLENWOOD BLVD",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757025055",
            "telephone_number": "903-535-9041"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5323 Harry Hines Blvd",
            "address_purpose": "LOCATION",
            "city": "Dallas",
            "state": "TX",
            "postal_code": "753909032",
            "country_code": "US",
            "telephone_number": "214-645-0967",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KUYKENDALL",
        "first_name": "MARISSA",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "CNM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-09-25",
        "last_updated": "2023-10-30",
        "certification_date": "2023-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "TX",
            "license": "AP143178",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1992356588",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARISSA",
            "last_name": "CANNON",
            "prefix": "MISS",
            "credential": "RN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Kunduru Dental PLLC
• Margaret Kunze
• Joseph Kalathil Kurian, M.D.
• Nikhil Kurpad, MD
• Rolake Ajike Kuye, PHARMD
• Marla Christine Kuykendall
• Ren Bradford Kuykendall, PA
• Maxwell Prosper Kwaku, MD
• Perpetual Serwaah Kyei, MLS
• Kyle Kennedy PHD LLC

• Advanced Practice Midwife in Tyler, TX
• Providers in Tyler, TX by specialty
• Advanced Practice Midwife in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2023; 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.

Verify at the official NPI Registry.