Angel Marshall

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

1195 Issued in MS

Practice address

206 Maryland Ave
McComb, MS 39648-3926

Phone

(601) 250-4815

NPI assigned

Oct 21, 2008

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

Enrolled in MS

Enrollment records 1

Specialty

Occupational Therapist in Private Practice

Education

Other, 1998

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Performance Therapy LLCGroup PAC ID 7012971047, 86 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• Performance Therapy LLC

  • Physical Therapist
  • Philadelphia, MS
  • NPI 1851427132
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1224547200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1224547200000",
    "number": "1205088358",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "820 CHARLIE DIXON RD",
            "city": "BRAXTON",
            "state": "MS",
            "postal_code": "390449314"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "206 MARYLAND AVE",
            "city": "MCCOMB",
            "state": "MS",
            "postal_code": "396483926",
            "telephone_number": "601-250-4815"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARSHALL",
        "first_name": "ANGEL",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-10-21",
        "last_updated": "2008-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MS",
            "license": "1195",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kimberly Lyles, MSW
• Janice Lyons
• Christie Magee, LSW
• Magnolia Family Medicine, PLLC
• Ivan Kai Makiyama, DO
• Debra Ann Marshall
• Martha Dale Kristiansen
• Irene Martin, CFNP
• Kassandria Martin
• Kelly H Martin, DPT,ATC

• Occupational Therapist in McComb, MS
• Providers in McComb, MS by specialty
• Occupational Therapist in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.