Active NPI
William Lewis Marr IV, PA-C
- Medical Physician Assistant
- Durango, CO
National Provider Identifier
1992801179
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Physician Assistant
- License
- PA.0008209
- Practice address
- 810 E 3Rd St Unit 201
Durango, CO 81301-5759 - Phone
- (970) 764-1790
- Fax
- (970) 375-7927
- NPI assigned
- Sep 15, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA01678 | TX | |
| Medical Physician Assistant | 363AM0700X | PA.0008209 | CO | Primary |
Addresses
Primary practice location
810 E 3Rd St Unit 201
Durango, CO 81301-5759
Mailing address
PO Box 802793
Kansas City, MO 64180-2793
Phone (800) 953-0104
Other practice location 1
1209 Highway 35 N
Rockport, TX 78382-4808
Phone (361) 729-9811
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| PA01678 | Other | TX | PA STATE LICENSE |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | william.marr@conviva.eclinicaldirectplus.com | Direct |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CO
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20231111000703 | CO | Practitioner - Physician Assistant | 8325049646 |
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 1996
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
Practice addresses (Care Compare)
9100 E Mineral Cir
Centennial, CO 80112-3401
Hospital & facility affiliations
- Mercy Regional Medical Center
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA01678 | TX | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Citizens Medical Center County of Victoria | Past | Accepting new patients |
Interoperability endpoints
- william.marr@conviva.eclinicaldirectplus.com
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.
-
- General Acute Care Hospital
- Victoria, TX
- NPI 1124052162
Hospital & facility affiliations 4
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Durango, CO
- NPI 1083611644
-
- General Acute Care Hospital
- Durango, CO
- NPI 1588204010
-
- General Acute Care Hospital
- Durango, CO
- NPI 1679113104
-
- General Acute Care Hospital
- Aztec, NM
- NPI 1770123382
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158278400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1741046400000",
"number": "1992801179",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 802793",
"city": "KANSAS CITY",
"state": "MO",
"postal_code": "641802793",
"telephone_number": "800-953-0104"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "810 E 3RD ST UNIT 201",
"city": "DURANGO",
"state": "CO",
"postal_code": "813015759",
"telephone_number": "970-764-1790",
"fax_number": "970-375-7927"
}
],
"practiceLocations": [
{
"address_1": "1209 Highway 35 N",
"address_purpose": "LOCATION",
"city": "Rockport",
"state": "TX",
"postal_code": "783824808",
"country_code": "US",
"telephone_number": "361-729-9811",
"fax_number": "361-729-9819",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MARR",
"first_name": "WILLIAM",
"middle_name": "LEWIS",
"name_prefix": "Mr.",
"name_suffix": "IV",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-09-15",
"last_updated": "2025-03-04",
"certification_date": "2025-03-04",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "TX",
"license": "PA01678",
"primary": false
},
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "CO",
"license": "PA.0008209",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PA STATE LICENSE",
"identifier": "PA01678",
"state": "TX"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "william.marr@conviva.eclinicaldirectplus.com",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"address_1": "1209 Highway 35 N",
"city": "Rockport",
"state": "TX",
"country_code": "US",
"postal_code": "783824808",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Durango, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2025; 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.