Nia Marshall

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

019.035200 Issued in IL

Practice address

811 W Wellington Ave
Chicago, IL 60657-5123

Phone

(773) 871-2188

Fax

(773) 871-6353

NPI assigned

Apr 2, 2024

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Networks

• devoted network organization-734447cc-691b-4aa7-a112-9c9c8698dcc9
• IL HMO C-SNP
• devoted network organization-27eb9117-6975-449a-a7ad-909243995ddc

Interoperability endpoints

• Direct secure messaging: nmarshall192148@uihealth.direct-ci.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• The Board of Trustees of the University of Illinois

  dba Uih-Mile Square Health Center

  • Federally Qualified Health Center (FQHC)
  • Chicago, IL
  • NPI 1669493466
  Medicare reassignment NPD
• The Board of Trustees of the University of Illinois

  dba Occupational Health Service Institute (OHSI)

  • Occupational Medicine Physician
  • Chicago, IL
  • NPI 1043727571
  NPD
• The Board of Trustees of the University of Illinois

  dba UI Health Mile Square Health Center L. P. Johnson Rockford

  • Federally Qualified Health Center (FQHC)
  • Rockford, IL
  • NPI 1306486022
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1712016000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718668800000",
    "number": "1003668252",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1857 DUNELLON DR",
            "city": "LYNDHURST",
            "state": "OH",
            "postal_code": "441243920"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "811 W WELLINGTON AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606575123",
            "telephone_number": "773-871-2188",
            "fax_number": "773-871-6353"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARSHALL",
        "first_name": "NIA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-04-02",
        "last_updated": "2024-06-18",
        "certification_date": "2024-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019.035200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Linda Marshall, MS, CRC
• Mary-Katherine Marshall
• Max Benjamin Marshall
• Megan Patricia Marshall, DDS
• Mikel Marshall, DC
• Niaira Marshall
• Patricia Ann Marshall, R.N.
• Robert Marshall, MD
• Sarah Jane Marshall, OTR/L
• Sharleeta Marshall, MA

• General Practice Dentistry in Chicago, IL
• Providers in Chicago, IL by specialty
• General Practice Dentistry in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.