MS. MARILYN M. PATTILLO (NPI# 1427010883) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1427010883 |
| Entity Type | Individual |
| Full Name | MS. MARILYN M. PATTILLO |
| Credential | APRN GNP |
| Practice Address |
3509 Rogge Ln Austin TX 78723-3640 |
| Mailing Address |
1700 Jackson Hole Cv Austin TX 78746-7634 |
| Practice Telephone | 5129262070 |
| Practice Fax Number | 5129269570 |
| Mailing Telephone | (512) 451-4488 |
| Mailing Fax Number | 5124532707 |
| Enumeration Date | 2006-04-03 |
| Last Update Date | 2017-09-06 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LG0600X |
Nurse Practitioner Specialization: Gerontology |
424864 | TX | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | BLUE CROSS PROVIDER NUMBE | NP7217 | 01 |
| Street Address |
3509 ROGGE LN |
| City | AUSTIN |
| State | TX |
| Zip Code | 78723-3640 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275521460 | Walnut Hills Nursing and Rehabilitation, Ltd. | Skilled Nursing Facility | 3509 Rogge Ln, Austin, TX 78723-3640 | 2005-10-11 |
| 1760024038 | Zarintaj Ali | Nurse Practitioner | 3509 Rogge Ln, Austin, TX 78723-3640 | 2019-10-08 |
| 1114310026 | Angelique Sanders | Speech-Language Pathologist | 3509 Rogge Ln, Austin, TX 78723-3640 | 2015-03-17 |
| 1962810465 | Coryell County Memorial Hospital Authority | Skilled Nursing Facility | 3509 Rogge Ln, Austin, TX 78723-3640 | 2014-07-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144787318 | Bridget Wilson | Counselor | 6448 East Hwy 290, Suite F108, Austin, TX 78723 | 2019-02-25 |
| 1700378999 | Andrew Christopher Shanks | Counselor | 2132 Antone St, Austin, TX 78723 | 2018-06-04 |
| 1316434236 | Yasaman Ahmadieh | Pediatrics | 4900 Mueller Boulevard, Suite 3s.066c, Austin, TX 78723 | 2018-04-16 |
| 1215433354 | Erika Senai Ramirez | Nurse Practitioner | 6900 Ed Bluestein Blvd, Austin, TX 78723 | 2018-04-05 |
| 1518477645 | Brigitte Tyree | Registered Nurse | 2237 Zach Scott St, Austin, TX 78723 | 2017-10-03 |
| 1942735980 | Ila Sehgal | Pediatrics | 4900 Mueller Blvd, Ste 3s.066c, Dell Children's Medical Center, Austin, TX 78723 | 2017-04-27 |
| 1851825194 | Terry Blackmon | Behavioral Analyst | 2021 Zach Scott St, Austin, TX 78723 | 2017-04-13 |
| 1114337961 | Cassandra Sorensen | Home Health | 3001 Maplelawn Circle, Austin, TX 78723 | 2014-05-02 |
| 1336569052 | Ricky C Mehta | Internal Medicine | 6210 E Hwy 290 Ste 420, Austin, TX 78723 | 2014-04-21 |
| 1356761373 | Peter Caldwell Gilbreath | Pediatrics | 4900 Mueller Boulevard, Suite 3s.066c, Dell Children's Medical Center, Austin, TX 78723 | 2014-04-17 |
| Find all providers in zip 78723 | ||||
| Taxonomy Code | 363LG0600X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Gerontology |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952804650 | Heidi Joonhee Kook-willis | Nurse Practitioner | 12731 Research Blvd Ste 301c, Austin, TX 78759-4383 | 2018-03-09 |
| 1639544794 | Susan Baby | Nurse Practitioner | 901 S Mopac Expressway, Building II Suite 130, Austin, TX 78746-5776 | 2015-12-01 |
| 1861878464 | Mary Gomez | Nurse Practitioner | 6806 Edinburgh Cv, Austin, TX 78749-2402 | 2015-08-05 |
| 1720310436 | Laurie Ann Ferraro | Nurse Practitioner | 4509 Norman Trl, Austin, TX 78749-1154 | 2010-02-04 |
| 1104909688 | Otis D Wright | Nurse Practitioner | 7005 Mira Loma Ln, Suite 102, Austin, TX 78723-1411 | 2006-10-20 |
| 1447287925 | Janice Moore | Nurse Practitioner | 7201 Ranch Road, 2222 Apt 3318, Austin, TX 78730-3228 | 2006-06-28 |
| 1023002722 | Milbrey Raney | Nurse Practitioner | 7201b Manchaca Rd, Austin, TX 78745-5259 | 2005-09-08 |
| 1013521780 | Sindhu Joseph | Nurse Practitioner | 6909 Burnet Ln, Austin, TX 78757 | 2020-09-01 |
| 1225527344 | Amber Chanel Armstrong | Nurse Practitioner | 313 E 12th St Ste 101, Austin, TX 78701-1955 | 2018-05-03 |
| 1811436439 | Peggy Bielke | Nurse Practitioner | 11211 Taylor Draper Ln, Austin, TX 78759-3916 | 2017-02-15 |
| Find all providers in AUSTIN | ||||
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| 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.