Individual provider Active NPI

Cathleen E Marshall, MD

  • Neurodevelopmental Disabilities Physician
  • Wasilla, AK
National Provider Identifier
1083957070
Registry record updated Oct 9, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurodevelopmental Disabilities PhysicianTaxonomy code 2084P0005X
License
163531 Issued in AK
Practice address
3505 E Meridian Park Loop Ste 100
Wasilla, AK 99654-7242
Phone
(907) 416-6594
Fax
(800) 248-6184
NPI assigned
Mar 28, 2013
Last updated
Oct 9, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 163531 AK
Neurology with Special Qualifications in Child Neurology Physician 2084N0402X 163531 AK
Neurodevelopmental Disabilities Physician 2084P0005X 163531 AK Primary

Addresses

Primary practice location

3505 E Meridian Park Loop Ste 100
Wasilla, AK 99654-7242

Mailing address

3505 E Meridian Park Loop Ste 100
Wasilla, AK 99654-7242
Phone (907) 416-6594

Other practice location 1

1405 Kellum St Ste 100
Fairbanks, AK 99701-4189
Phone (907) 416-6594

Other practice location 2

4000 Old Seward Hwy Ste 301
Anchorage, AK 99503-6068
Phone (907) 416-6594

Other identifiers 1

IdentifierTypeStateIssuer
1711197MedicaidAK

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AK
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251217003784 AK Practitioner - Neurology 8224349659 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northern Neurology LLCGroup PAC ID 6204377435, 4 clinicians

Practice addresses (Care Compare)

3505 E Meridian Park Loop
Suite 100
Wasilla, AK 99654-7242
Phone (855) 431-8555

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
163531AKMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Northern Neurology, LLC CurrentSince Nov 1, 2025 Accepting new patients
Ptarmigan Connections, LLC Pediatrics Past Accepting new patients
Providence Health & Services-Washington PastSince Nov 11, 2020 Accepting new patients

Locations

4000 Old Seward Hwy
Ste 301
Anchorage, AK 99503
Phone (907) 416-6594

1405 Kellum St
Fairbanks, AK 99701
Phone (855) 431-8555

1405 Kellum St
Ste 100
Fairbanks, AK 99701
Phone (907) 416-6594

3505 E Meridian Park Loop
Ste 100
Wasilla, AK 99654
Phone (907) 357-4963

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1364428800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1791504000000",
    "number": "1083957070",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3505 E MERIDIAN PARK LOOP STE 100",
            "city": "WASILLA",
            "state": "AK",
            "postal_code": "996547242",
            "telephone_number": "907-416-6594",
            "fax_number": "800-654-6250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3505 E MERIDIAN PARK LOOP STE 100",
            "city": "WASILLA",
            "state": "AK",
            "postal_code": "996547242",
            "telephone_number": "907-416-6594",
            "fax_number": "800-248-6184"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1405 Kellum St Ste 100",
            "address_purpose": "LOCATION",
            "city": "Fairbanks",
            "state": "AK",
            "postal_code": "997014189",
            "country_code": "US",
            "telephone_number": "907-416-6594",
            "fax_number": "800-654-6250",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4000 Old Seward Hwy Ste 301",
            "address_purpose": "LOCATION",
            "city": "Anchorage",
            "state": "AK",
            "postal_code": "995036068",
            "country_code": "US",
            "telephone_number": "907-416-6594",
            "fax_number": "800-654-6250",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MARSHALL",
        "first_name": "CATHLEEN",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-03-28",
        "last_updated": "2026-10-09",
        "certification_date": "2026-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "AK",
            "license": "163531",
            "primary": false
        },
        {
            "code": "2084N0402X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology",
            "state": "AK",
            "license": "163531",
            "primary": false
        },
        {
            "code": "2084P0005X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurodevelopmental Disabilities",
            "state": "AK",
            "license": "163531",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1711197",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wasilla, AK

Sources for this page

Verify at the official NPI Registry.