MARISSA MARIE GALAN RAVAN (NP) – Nurse Practitioner, NPI 1235742503

MARISSA MARIE GALAN RAVAN (NP) is a healthcare provider. based in Stockbridge, Georgia. specializing in NURSE PRACTITIONER. They hold the professional credentials NP. They hold a License No. RN268489 (GA). The NPI Number for MARISSA MARIE GALAN RAVAN (NP) is 1235742503

Main info

Female
6 Years Of Experience
Accepts Medicare Assignment
Name
MARISSA MARIE GALAN RAVAN (NP)
NPI
1235742503
Phone
(770) 771-6580
Address
1365 ROCK QUARRY RD STE 202
Enumeration Date
26 August 2020
Last Update Date
17 October 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
7709602701
Graduation Year
2020 (6 years ago)
PAC ID
1850701384
Group Practice PAC ID
0244395689
Professional Enrollment ID
I20201111002407
Address ID
GA302815023ST1365XRDXX402
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience34
Completeness85
Years active:5State licenses:1Digital endpointsOther names

9,744 NURSE PRACTITIONER in GA

Provider Addresses for MARISSA MARIE GALAN RAVAN (NP)

  • 1365 ROCK QUARRY RD STE 202

    STOCKBRIDGE, GA 302815023

    Phone: (770) 771-6580

    Fax: (770) 771-6589

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 24 Open Payments records for all available years, with a total value of $1,068.

Total Amount is formed as General ($1,068) + Research ($0) + Ownership ($0) = $1,068.

Last reported payment date: 2024-08-14 • Largest payer in this snapshot: Relievant Medsystems, Inc. ($629).

Total Amount

$1,068

General + Research + Ownership

Payments

24

Total payment records

General Amount

$1,068

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-08-14

Latest reported date

View all Open Payments →|Open Payments Risk Radar →

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2020-11-11

PECOS data refreshed: 2026-06-15

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20201111002407INurse PractitionerGATBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 30281)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 0244395689View full group profile
NameSpecialtyState
Nurse PractitionerAL
A N E S T H E S I O L O G YFL
Physical Medicine And Rehabilitation, Interventional Pain ManagementGA
A N E S T H E S I O L O G YGA
Interventional Pain Management, AnesthesiologyMA
Physical Medicine And RehabilitationGA

Reviews

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Frequently asked questions

What is the registry number for MARISSA MARIE GALAN RAVAN (NP)?
The registry entry for MARISSA MARIE GALAN RAVAN (NP) shows NPI 1235742503.
Is MARISSA MARIE GALAN RAVAN (NP) currently accepting referrals based on NPI status?
Registry metadata lists MARISSA MARIE GALAN RAVAN (NP) as active.
What services align with MARISSA MARIE GALAN RAVAN (NP)'s listing?
MARISSA MARIE GALAN RAVAN (NP)'s public classification highlights Nurse Practitioner. Clinical services aligned with this taxonomy classification.
Is MARISSA MARIE GALAN RAVAN (NP) tied to Stockbridge, Georgia?
If you are local to Stockbridge, Georgia, MARISSA MARIE GALAN RAVAN (NP) may be relevant to your search.
Why is information missing for MARISSA MARIE GALAN RAVAN (NP)?
Providers choose how much contact data to publish. Missing fields do not mean the profile is fake.

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