Individual provider Active NPI

Daniel P Marshall, M.D.

  • General Practice Physician
  • Memphis, TN
National Provider Identifier
1295863488
Registry record updated Mar 16, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
MD0000009649 Issued in TN
Practice address
515 N Highland St
Memphis, TN 38122-4572
Phone
(901) 323-1200
Fax
(901) 452-6823
NPI assigned
Mar 1, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 16, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X MD0000009649 TN Primary

Addresses

Primary practice location

515 N Highland St
Memphis, TN 38122-4572

Mailing address

515 N Highland St
Memphis, TN 38122-4572
Phone (901) 323-1200

Other identifiers 1

IdentifierTypeStateIssuer
0026833OtherTNBLUE BROSS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100902000659 TN Practitioner - General PracticePractitioner - Preventive Medicine 2769506393 Practice locations: Memphis, TN

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD0000009649TNMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Alpine Dermatology Clinic P.C. Past Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1172707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1268697600000",
    "number": "1295863488",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "515 N HIGHLAND ST",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381224572",
            "telephone_number": "901-323-1200",
            "fax_number": "901-452-6823"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "515 N HIGHLAND ST",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381224572",
            "telephone_number": "901-323-1200",
            "fax_number": "901-452-6823"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARSHALL",
        "first_name": "DANIEL",
        "middle_name": "P",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-01",
        "last_updated": "2010-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "TN",
            "license": "MD0000009649",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE BROSS",
            "identifier": "0026833",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Memphis, TN

Sources for this page

Verify at the official NPI Registry.