Individual provider Active NPI

Allan Marshall, P.A.-C

  • Physician Assistant
  • Spokane, WA
National Provider Identifier
1215079991
Registry record updated Mar 1, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
10001608 Issued in WA
Practice address
5633 N Lidgerwood
Spokane, WA 99208
Phone
(509) 482-2448
Fax
(509) 482-2452
NPI assigned
Feb 12, 2007
Last updated
Mar 1, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 1, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA10001608 WA
Physician Assistant 363A00000X 10001608 WA Primary

Addresses

Primary practice location

5633 N Lidgerwood
Spokane, WA 99208

Mailing address

5633 N Lidgerwood
Spokane, WA 99208
Phone (509) 482-2448

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090309000356 WA Practitioner - Physician Assistant 9830255330 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
96.16 of 100Reported as group
Quality
91.17
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
10001608WAMDPhysician Assistant

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1171238400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1298937600000",
    "number": "1215079991",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5633 N LIDGERWOOD",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "99208",
            "telephone_number": "509-482-2448",
            "fax_number": "509-482-2452"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5633 N LIDGERWOOD",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "99208",
            "telephone_number": "509-482-2448",
            "fax_number": "509-482-2452"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARSHALL",
        "first_name": "ALLAN",
        "credential": "P.A.-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-12",
        "last_updated": "2011-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "WA",
            "license": "PA10001608",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WA",
            "license": "10001608",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Spokane, WA

Sources for this page

Verify at the official NPI Registry.