Individual provider Active NPI

Sandy Marshall, FNP

  • Family Nurse Practitioner
  • Rolla, MO
National Provider Identifier
1316341944
Registry record updated Aug 22, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
2014036362 Issued in MO
Practice address
1000 W 10TH St
Rolla, MO 65401-2905
Phone
(573) 458-8899
NPI assigned
Oct 10, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 2014036362 MO Primary

Addresses

Primary practice location

1000 W 10TH St
Rolla, MO 65401-2905

Mailing address

1050 W 10TH St
Attn: Executive Director of Physician Clinics
Rolla, MO 65401-2905
Phone (573) 364-9000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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
I20141121000338 MO Practitioner - Nurse Practitioner 1456573716 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pcrmc Medical Group IncGroup PAC ID 1557454063, 113 clinicians

Practice addresses (Care Compare)

1050 W 10TH St
Rolla, MO 65401-2905
Phone (573) 364-9000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
2014036362MOMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Pcrmc Medical Group, Inc CurrentSince Apr 1, 2016 Accepting new patients

Locations

603 S Bishop Ave
Rolla, MO 65401
Phone (573) 426-4411

1000 W 10th St
Rolla, MO 65401
Phone (573) 364-9000

1050 W 10th St
Rolla, MO 65401
Phone (573) 364-9000

1050 W 10th St
Ste 480
Rolla, MO 65401
Phone (573) 364-1900

1000 Gw Ln
Waynesville, MO 65583
Phone (573) 774-2715

Organizations & group practices 2

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1412899200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566432000000",
    "number": "1316341944",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1050 W 10TH ST",
            "address_2": "ATTN: EXECUTIVE DIRECTOR OF PHYSICIAN CLINICS",
            "city": "ROLLA",
            "state": "MO",
            "postal_code": "654012905",
            "telephone_number": "573-364-9000",
            "fax_number": "573-426-2108"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 W 10TH ST",
            "city": "ROLLA",
            "state": "MO",
            "postal_code": "654012905",
            "telephone_number": "573-458-8899"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARSHALL",
        "first_name": "SANDY",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-10-10",
        "last_updated": "2019-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2014036362",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rolla, MO

Sources for this page

Verify at the official NPI Registry.