EMILY M MARRIS (NPI# 1689191736) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1689191736 |
| Entity Type | Individual |
| Full Name | EMILY M MARRIS |
| Credential | PA |
| Practice Address |
4103 Medical Center Dr Fayetteville NY 13066-6600 |
| Mailing Address |
301 Prospect Ave Rm 1605 Syracuse NY 13203-1807 |
| Practice Telephone | 3157441500 |
| Practice Fax Number | 3156377808 |
| Mailing Telephone | 3157441819 |
| Enumeration Date | 2017-08-29 |
| Last Update Date | 2017-08-29 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | NY | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
4103 MEDICAL CENTER DR |
| City | FAYETTEVILLE |
| State | NY |
| Zip Code | 13066-6600 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396748414 | Andrew L Finley | Emergency Medicine | 4103 Medical Center Dr, Fayetteville, NY 13066-6600 | 2005-05-23 |
| 1225397805 | Sarah Kathryn Leo | Registered Nurse | 4103 Medical Center Dr, Fayetteville, NY 13066-6600 | 2012-05-16 |
| 1902134216 | Hannah Lovallo | Physician Assistant | 4103 Medical Center Dr, Fayetteville, NY 13066-6600 | 2009-11-24 |
| 1386811545 | Renee Anne Ryan | Emergency Medicine | 4103 Medical Center Dr, Fayetteville, NY 13066-6600 | 2008-05-15 |
| 1487852851 | Mark A Profetto | Nurse Practitioner | 4103 Medical Center Dr, Fayetteville, NY 13066-6600 | 2007-07-06 |
| 1790819126 | Anita D O'malley | Physician Assistant | 4103 Medical Center Dr, Fayetteville, NY 13066-6600 | 2007-03-15 |
| 1144367749 | Nerissa Ann Jackson | Physician Assistant | 4103 Medical Center Dr, Fayetteville, NY 13066-6600 | 2007-01-31 |
| 1841206356 | Linda M Goff | Nurse Practitioner | 4103 Medical Center Dr, Fayetteville, NY 13066-6600 | 2006-08-01 |
| 1215990536 | Stephen J Jackowski | Physician Assistant | 4103 Medical Center Dr, Fayetteville, NY 13066-6600 | 2006-04-08 |
| 1740283829 | Audrey A Mathis | Registered Nurse | 4103 Medical Center Dr, Fayetteville, NY 13066-6600 | 2005-05-23 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457819963 | Word Wellness Center, LLC | Psychologist | 6836 E Genesee Street, Suite A, Fayetteville, NY 13066 | 2019-03-05 |
| 1629529060 | Lorna Boyer Chase | Marriage & Family Therapist | 109 White Heron Circle, Fayetteville, NY 13066 | 2016-10-20 |
| 1699221432 | Roman Batyuk | Nurse Practitioner | 4100 Medical Center Drive, Fayetteville, NY 13066 | 2016-08-31 |
| 1427405133 | National Eye Care, Inc | Optometrist | 5160 Kinloch Circle, Fayetteville, NY 13066 | 2016-05-23 |
| 1013375328 | Kristin Kukenberger | Chiropractor | 7000 E Genesee St Bldg B, Fayetteville, NY 13066 | 2016-02-01 |
| 1124394671 | Susan Hartman Brenizer | Marriage & Family Therapist | 7000 E Genesee St Lyndon Office Park, Bldg. A, Second Floor (upper Level), Fayetteville, NY 13066 | 2012-03-29 |
| 1245541432 | Rene L Converse | Occupational Therapist | 7200 E. Genesee Street, Fayetteville, NY 13066 | 2010-06-23 |
| 1689815805 | Menorah Park Group Residents | Clinic/Center | 12 Jamar Drive, Dewitt, NY 13066 | 2009-03-18 |
| 1063677458 | John Marcena Glezen | Obstetrics & Gynecology | 1 The Gazebo, Fayetteville, NY 13066 | 2008-07-24 |
| 1629232418 | Tucker Martin Harris | Otolaryngology | 4000 Medical Center Dr # 117, Fayetteville, NY 13066 | 2008-07-11 |
| Find all providers in zip 13066 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306443387 | Melissa Macneil Spencer | Physician Assistant | 810 Knighthood Cir, Fayetteville, NY 13066-8721 | 2020-10-03 |
| 1366067548 | Prathna Raval | Physician Assistant | 6808 Thames Dr, Fayetteville, NC 28306-2524 | 2020-06-12 |
| 1205465895 | Gillian Vaughan Heard | Physician Assistant | 1275 Ga-54 #201, Fayetteville, GA 30214 | 2020-04-06 |
| 1144858515 | Mackenzie Anna Kirchner | Physician Assistant | 568 Sandy Creek Rd, Fayetteville, GA 30214-4205 | 2020-03-31 |
| 1770116931 | Chasity Nicole Sullivan | Physician Assistant | 202b Highland Ave, Fayetteville, NC 28305-5308 | 2020-02-17 |
| 1740812833 | Madeline Everitt Monday | Physician Assistant | 705 Stonington Dr, Fayetteville, NC 28311-0329 | 2020-02-07 |
| 1396375325 | Lisa Ann Gross | Physician Assistant | 3007 Town Center Dr Ste 100, Fayetteville, NC 28306-3663 | 2020-01-17 |
| 1811536048 | Kelly Hamilton Sweatt | Physician Assistant | 1991 Fordham Dr Ste 200, Fayetteville, NC 28304-3774 | 2020-01-06 |
| 1922563667 | Reandy Nicole Hearn | Physician Assistant | 2911 Breezewood Ave Ste 100, Fayetteville, NC 28303-5464 | 2019-02-06 |
| 1790259430 | Cassandra Ann Nebosky-diaz | Physician Assistant | 659 Daharan Dr, Fayetteville, NC 28314-6538 | 2019-01-16 |
| Find all providers in FAYETTEVILLE | ||||
| City | FAYETTEVILLE |
| Zip Code | 13066 |
Please comment or provide details below to improve the information on EMILY M MARRIS.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.