Karen Marshall, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA9105345 Issued in FL

Practice address

426 SW Commerce Dr
Suite 101
Lake City, FL 32025-1505

Phone

(386) 755-2240

Fax

(386) 755-6598

NPI assigned

Jan 15, 2010

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Physician Assistant

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 and National Provider Directory roles.

• Grace Pediatrics PL

  • Rural Health Clinic/Center
  • Fort White, FL
  • NPI 1326885294
  NPD (past)
• Grace Pediatrics PL

  • Pediatric Nurse Practitioner
  • Lake City, FL
  • NPI 1720362429
  NPD (past)

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

{
    "created_epoch": "1263513600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1386201600000",
    "number": "1205167129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "426 SW COMMERCE DR",
            "address_2": "SUITE 101",
            "city": "LAKE CITY",
            "state": "FL",
            "postal_code": "320251505",
            "telephone_number": "386-755-2240",
            "fax_number": "386-755-6598"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "426 SW COMMERCE DR",
            "address_2": "SUITE 101",
            "city": "LAKE CITY",
            "state": "FL",
            "postal_code": "320251505",
            "telephone_number": "386-755-2240",
            "fax_number": "386-755-6598"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARSHALL",
        "first_name": "KAREN",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-01-15",
        "last_updated": "2013-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9105345",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "002200000",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sheila Markham Manning
• Eric Alberto Marquez Guerra, M.D.
• Clara R Marr
• Yashira M Marrero Smith, RN
• Breeanna D Marshall
• Martin Kids Dental Health Team of Lake City, PLLC
• Andrew P Martin, DMD
• Angel Priscilla Martin
• Celia Susan Martin, D.M.D
• Michaelnisha R Martin

• Physician Assistant in Lake City, FL
• Providers in Lake City, FL by specialty
• Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.