Individual provider Active NPI

William Lewis Marr IV, PA-C

  • Medical Physician Assistant
  • Durango, CO
National Provider Identifier
1992801179
Registry record updated Mar 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA.0008209 Issued in CO
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

Updated by the provider on Mar 4, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
PA01678OtherTXPA STATE LICENSE

Electronic endpoints 1

TypeEndpointUseAffiliation
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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
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 Hospital, Durango, CO, CCN 060013

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA01678TXMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Citizens Medical Center County of Victoria Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: 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.

Hospital & facility affiliations 4

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": "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

Verify at the official NPI Registry.