Jeffrey Tonkins Marshall, MA

Primary specialty

PsychologistTaxonomy code 103T00000X

License

1663 Issued in NC

Practice address

5749 Ruth Dr
Charlotte, NC 28215-2231

Phone

(704) 763-0687

NPI assigned

Mar 14, 2007

Sex

Male

Sole proprietor

Yes

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

Master of Arts

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.

• Community Psychological Resources, LLC

  • Community/Behavioral Health Agency
  • Charlotte, NC
  • NPI 1124329271
  NPD (past) Authorized official

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

{
    "created_epoch": "1173830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1369699200000",
    "number": "1346373750",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5749 RUTH DR",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282152231",
            "telephone_number": "704-763-0687"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5749 RUTH DR",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282152231",
            "telephone_number": "704-763-0687"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARSHALL",
        "first_name": "JEFFREY",
        "middle_name": "TONKINS",
        "name_prefix": "Mr.",
        "credential": "MA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-14",
        "last_updated": "2013-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NC",
            "license": "1663",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6107028",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Darril Gerard Marshall Jr.
• Edwin Kim Marshall Jr., PA
• Faye Marshall
• Hope Lee Marshall, LCAS, CCJP
• Javan Marshall
• Katherine Margaret Marshall, MSW, LCSW-A
• Kathryn Marshall, MS, SSP
• Kelli Esther Marshall
• Kina L Marshall, RECREATION THERAPIST
• Makenzie Marshall, DNP, FNP-C

• Psychologist in Charlotte, NC
• Providers in Charlotte, NC by specialty
• Psychologist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 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.