Active NPI
Walter H Marshall, M.D.
- Ophthalmology Physician
- Gainesville, FL
National Provider Identifier
1184684359
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ophthalmology Physician
- License
- ME20358
- Practice address
- 708 E University Ave
Gainesville, FL 32601-5509 - Phone
- (352) 373-4300
- Fax
- (352) 372-1641
- NPI assigned
- Mar 23, 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 |
|---|---|---|---|---|
| Ophthalmology Physician | 207W00000X | ME20358 | FL | Primary |
Addresses
Primary practice location
708 E University Ave
Gainesville, FL 32601-5509
Mailing address
708 E University Ave
Gainesville, FL 32601-5509
Phone (352) 373-4300
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 01223 | Other | FL | BLUE CROSS BLUE SHIELD FL |
| 0570265000 | Medicaid | FL | |
| 4311146 | Other | FL | AETNA |
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 Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ME20358 | FL | MD | Ophthalmology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1143072000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1200614400000",
"number": "1184684359",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "708 E UNIVERSITY AVE",
"city": "GAINESVILLE",
"state": "FL",
"postal_code": "326015509",
"telephone_number": "352-373-4300",
"fax_number": "352-372-1641"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "708 E UNIVERSITY AVE",
"city": "GAINESVILLE",
"state": "FL",
"postal_code": "326015509",
"telephone_number": "352-373-4300",
"fax_number": "352-372-1641"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARSHALL",
"first_name": "WALTER",
"middle_name": "H",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-03-23",
"last_updated": "2008-01-18",
"status": "A"
},
"taxonomies": [
{
"code": "207W00000X",
"taxonomy_group": "",
"desc": "Ophthalmology",
"state": "FL",
"license": "ME20358",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD FL",
"identifier": "01223",
"state": "FL"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0570265000",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "4311146",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Gainesville, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 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.