Angela R Marshall, PSYD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

20041898A Issued in IN

Practice address

901 S Rogers St
Suite 205
Bloomington, IN 47403-4756

Phone

(812) 345-5114

Fax

(812) 339-0369

NPI assigned

Sep 25, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

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

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Jul 1, 2019 through Jul 1, 2027

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Angela R Marshall PSYD LLC

  • Clinical Psychologist
  • Bloomington, IN
  • NPI 1639387590
  NPD (past) Authorized official
• Angela R Marshall PSYD Inc

  • Clinical Psychologist
  • Bloomington, IN
  • NPI 1033394101
  NPD (past)
• Pain Management Center of Southern Indiana, Inc.

  • Multi-Specialty Clinic/Center
  • Bloomington, IN
  • NPI 1629063797
  NPD (past)
• University of Minnesota Physicians

  • Multi-Specialty Clinic/Center
  • Minneapolis, MN
  • NPI 1477598118
  NPD (past)

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

{
    "created_epoch": "1159142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1154421295",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2164",
            "city": "BLOOMINGTON",
            "state": "IN",
            "postal_code": "474022164",
            "telephone_number": "812-345-5114",
            "fax_number": "812-339-0369"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 S ROGERS ST",
            "address_2": "SUITE 205",
            "city": "BLOOMINGTON",
            "state": "IN",
            "postal_code": "474034756",
            "telephone_number": "812-345-5114",
            "fax_number": "812-339-0369"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARSHALL",
        "first_name": "ANGELA",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-25",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IN",
            "license": "20041898A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Charlotte I Marks, PA
• Emma Marschel, RBT
• Marsh Drugs LLC
• Marsh Drugs LLC
• Dana Michele Marsh, MSN, FNP-BC
• Ed Marshall, O.D.
• Jennifer Marshall
• Jessica Robin Marshall, HIS
• Alicia Marte, MSN, RN, CNE
• Mary Elise Marte, OD

• Clinical Psychologist in Bloomington, IN
• Providers in Bloomington, IN by specialty
• Clinical Psychologist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.