NPIMap

Organization Active NPI

Marshall Radiology PC

  • Diagnostic Radiology Physician
  • Boaz, AL
National Provider Identifier
1184650228
Registry record updated Jun 21, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
Legal business name
MARSHALL RADIOLOGY PC
Practice address
2505 US Highway 431
Boaz, AL 35957-5908
Phone
(256) 840-3688
NPI assigned
Jun 23, 2006
Last updated
Jun 21, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 21, 2016

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

Authorized official

Name
Dr. Lisa Driskill, MDNPI 1376588350
Title
President
Phone
(706) 271-0100

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
Diagnostic Radiology Physician 2085R0202X Primary

Addresses

Primary practice location

2505 US Highway 431
Boaz, AL 35957-5908

Mailing address

PO Box 1164
Dalton, GA 30722-1164
Phone (706) 271-0100

Other identifiers 2

IdentifierTypeStateIssuer
529918000MedicaidAL
DA4610OtherALRR MEDICARE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040524000837 AL Part B Supplier - Clinic/Group Practice 3274524574 Receives reassigned benefits from 8 practitioners
Practice locations: Albertville, AL; Gunterville, AL; Boaz, AL

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 14

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1151020800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1466467200000",
    "number": "1184650228",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1164",
            "city": "DALTON",
            "state": "GA",
            "postal_code": "307221164",
            "telephone_number": "706-271-0100",
            "fax_number": "706-270-0487"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2505 US HIGHWAY 431",
            "city": "BOAZ",
            "state": "AL",
            "postal_code": "359575908",
            "telephone_number": "256-840-3688"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARSHALL RADIOLOGY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-23",
        "last_updated": "2016-06-21",
        "status": "A",
        "authorized_official_last_name": "DRISKILL",
        "authorized_official_first_name": "LISA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "706-271-0100",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "529918000",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "DA4610",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Boaz, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2016; 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.