Individual provider Active NPI

Sharon Crimmins Marx, M.D.

  • Geriatric Medicine (Internal Medicine) Physician
  • Minnetonka, MN
National Provider Identifier
1992856553
Registry record updated Jun 30, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X
License
29870 Issued in MN
Practice address
9701 Data Park
Mn006-W600
Minnetonka, MN 55343-9026
Phone
(800) 896-8936
Fax
(888) 866-3209
NPI assigned
Jan 12, 2007
Last updated
Jun 30, 2009By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 30, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Medicine (Internal Medicine) Physician 207RG0300X 29870 MN Primary

Addresses

Primary practice location

9701 Data Park
Mn006-W600
Minnetonka, MN 55343-9026

Mailing address

5822 Vernon LN
Edina, MN 55436-2250

Other identifiers 1

IdentifierTypeStateIssuer
8600805-00MedicaidMN

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
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
United Healthcare Services, Inc 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1168560000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1246320000000",
    "number": "1992856553",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5822 VERNON LN",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554362250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9701 DATA PARK",
            "address_2": "MN006-W600",
            "city": "MINNETONKA",
            "state": "MN",
            "postal_code": "553439026",
            "telephone_number": "800-896-8936",
            "fax_number": "888-866-3209"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARX",
        "first_name": "SHARON",
        "middle_name": "CRIMMINS",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-12",
        "last_updated": "2009-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "MN",
            "license": "29870",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8600805-00",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Minnetonka, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2009; 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.