MARY BETH MARBURGER (CRNP) – Women's Health Nurse Practitioner, NPI 1104106160

MARY BETH MARBURGER (CRNP) is a healthcare provider. based in Canton, Ohio. specializing in NURSE PRACTITIONER. They hold the professional credentials CRNP. They hold a License No. COA.12554-NP (OH). The NPI Number for MARY BETH MARBURGER (CRNP) is 1104106160

Main info

Female
Sole Proprietor
15 Years Of Experience
Accepts Medicare Assignment
Name
MARY BETH MARBURGER (CRNP)
NPI
1104106160
Phone
(330) 492-8001
Address
4151 HOLIDAY ST NW
Enumeration Date
23 August 2011
Last Update Date
9 March 2016

Doctor Profile

Medical School Name
OTHER
Secondary Phone
3303644600
Graduation Year
2011 (15 years ago)
PAC ID
6406298447
Group Practice PAC ID
6002916194
Professional Enrollment ID
I20240522003312
Address ID
OH446222162DO420XXAVEX402
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience42
Completeness75
Years active:14State licenses:1Digital endpointsOther names

14,984 NURSE PRACTITIONER in OH

Provider Addresses for MARY BETH MARBURGER (CRNP)

  • 4151 HOLIDAY ST NW

    CANTON, OH 447182531

    Phone: (330) 492-8001

    Fax: (330) 492-2080

    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 23 Open Payments records for all available years, with a total value of $504.

Total Amount is formed as General ($504) + Research ($0) + Ownership ($0) = $504.

Last reported payment date: 2024-03-21 • Largest payer in this snapshot: Astellas Pharma US Inc ($138).

Total Amount

$504

General + Research + Ownership

Payments

23

Total payment records

General Amount

$504

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-03-21

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: 2024-05-22

PECOS data refreshed: 2026-05-27

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
I20240522003312INurse PractitionerOHTBD

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 44718)

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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: 6002916194View full group profile
NameSpecialtyState
Cardiovascular Disease (Cardiology)OH
Cardiovascular Disease (Cardiology)OH
Cardiovascular Disease (Cardiology), Internal MedicineOH
Nurse PractitionerOH
Certified Registered Nurse Anesthetist (Crna)PA
Certified Nurse Midwife (Cnm)OH
Physician AssistantOH
Internal Medicine, Family PracticeOH
-NC
Nurse PractitionerOH

Reviews

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Frequently asked questions

What unique ID ties claims to MARY BETH MARBURGER (CRNP)?
NPI 1104106160 is assigned to MARY BETH MARBURGER (CRNP) under the national enumeration system.
Is MARY BETH MARBURGER (CRNP)'s enrollment marked active?
An active flag here means the NPI record is not in a deactivated state.
Can you summarize MARY BETH MARBURGER (CRNP)'s specialty in plain language?
Clinically, the directory lists MARY BETH MARBURGER (CRNP) with Women's Health Nurse Practitioner. Clinical services aligned with this taxonomy classification.
What location metadata exists for MARY BETH MARBURGER (CRNP)?
The page summarizes Canton, Ohio for MARY BETH MARBURGER (CRNP); expand the address list for detail.
Is MARY BETH MARBURGER (CRNP) a real provider?
This page reflects official NPPES data for NPI 1104106160. Always confirm identity and privileges with the practice and licensing boards.

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