Active NPI
Richard M Marshall, PHD
- Clinical Psychologist
- Tampa, FL
National Provider Identifier
1093829301
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- SS328
- Practice address
- 12901 Bruce B Downs Blvd
Tampa, FL 33612-4742 - Phone
- (813) 974-1516
- NPI assigned
- Aug 17, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | SS328 | FL | Primary |
Addresses
Primary practice location
12901 Bruce B Downs Blvd
Tampa, FL 33612-4742
Mailing address
PO Box 917770
Orlando, FL 32891-7770
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| Z067X | Other | FL | BLUE CROSS BLUE SHIELD |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Psychological Associates of Central Florida | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Lakeland, FL
- NPI 1538570080
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155772800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1205798400000",
"number": "1093829301",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 917770",
"city": "ORLANDO",
"state": "FL",
"postal_code": "328917770"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12901 BRUCE B DOWNS BLVD",
"city": "TAMPA",
"state": "FL",
"postal_code": "336124742",
"telephone_number": "813-974-1516"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARSHALL",
"first_name": "RICHARD",
"middle_name": "M",
"credential": "PHD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-17",
"last_updated": "2008-03-18",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "FL",
"license": "SS328",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "Z067X",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Tampa, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.