MR. KELLY MARCUM NP
NPI 1619973930
Nurse Practitioner - Family in Overgaard, AZ

Q: What is Kelly Marcum's NPI number?

The NPI number for Kelly Marcum is 1619973930. It was assigned to this individual provider in the NPPES registry on June 22, 2005.

Q: What is Kelly Marcum's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Q: When was this NPI record last updated?

The NPPES record for Kelly Marcum was last updated on December 30, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since June 22, 2005

2931 S HWY 260, OVERGAARD, AZ 85933(928) 536-3616(928) 536-3615 Get Directions Write a Review

NPPES record last updated: December 30, 2013. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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About Mr. Kelly Marcum Np NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MR. KELLY MARCUM NP (NPI 1619973930) is an individual family provider in Overgaard, Arizona, licensed in Arizona (RN036514) and active in the NPI registry since June 2005.

NPPES Registry Identity

NPI1619973930

Entity TypeIndividualMale

Primary Taxonomy363LF0000X

Provider Legal NameMR. KELLY MARCUMCredential: NP

Location Address2931 S HWY 260Overgaard, AZ 85933

Mailing Address2200 E Show Low Lake RdShow Low, AZ 85901 · (928) 537-6978 · Fax (928) 537-4205

Phone(928) 536-3616

Fax(928) 536-3615

Sole ProprietorNo

Enumeration DateJune 22, 2005

Last NPPES UpdateDecember 30, 2013

✔ NPI 1619973930 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LF0000X

License✔ Licensed in AZ · RN036514

2931 S HWY 260, Overgaard, AZ 85933

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Other Identifiers 1

Medicare UPINQ49838AZ

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kelly Marcum's NPI number?

The NPI number for Kelly Marcum is 1619973930. It was assigned to this individual provider in the NPPES registry on June 22, 2005.

Where is Kelly Marcum located?

Kelly Marcum practices at 2931 S Hwy 260, Overgaard, AZ 85933. The listed phone number is (928) 536-3616.

What is Kelly Marcum's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

When was this NPI record last updated?

The NPPES record for Kelly Marcum was last updated on December 30, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.