Organization Active NPI

Marshall Health and Wellness

  • Nurse Practitioner
  • Canton, OH
National Provider Identifier
1124637467
Registry record updated Jul 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
Legal business name
MARSHALL HEALTH AND WELLNESS
Practice address
6535 Market Ave N Ste 110
Canton, OH 44721-2487
Phone
(330) 324-0979
NPI assigned
Jul 22, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2020

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

Authorized official

Name
Kimberly Marshall, APRN-BCNPI 1710909197
Title
Owner
Phone
(330) 324-0979

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363L00000X Primary

Addresses

Primary practice location

6535 Market Ave N Ste 110
Canton, OH 44721-2487

Mailing address

6535 Market Ave N Ste 110
Canton, OH 44721-2487
Phone (330) 324-0979

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200904001202 OH Part B Supplier - Clinic/Group Practice 9032536081 Receives reassigned benefits from 1 practitioner
Practice locations: Canton, OH

National Provider Directory

National Provider Directory

Locations

6535 Market Ave N
Ste 110
Canton, OH 44721
Phone (330) 324-0979

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1595376000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1595376000000",
    "number": "1124637467",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6535 MARKET AVE N STE 110",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447212487",
            "telephone_number": "330-324-0979"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6535 MARKET AVE N STE 110",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447212487",
            "telephone_number": "330-324-0979"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARSHALL HEALTH AND WELLNESS",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-07-22",
        "last_updated": "2020-07-22",
        "certification_date": "2020-07-22",
        "status": "A",
        "authorized_official_last_name": "MARSHALL",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "330-324-0979",
        "authorized_official_credential": "APRN-BC"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Canton, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.