NPIMap

Individual provider Active NPI

Trista Jacinta Marshall, M.D.

  • Physical Medicine & Rehabilitation Physician
  • Macon, GA
National Provider Identifier
1346484763
Registry record updated Mar 13, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
068927 Issued in GA
Practice address
3351 Northside Dr
Macon, GA 31210-2587
Phone
(478) 201-6500
NPI assigned
Apr 29, 2009
Last updated
Mar 13, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 13, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X 068927 GA Primary

Addresses

Primary practice location

3351 Northside Dr
Macon, GA 31210-2587

Mailing address

3022 Castlewoods Dr
Macon, GA 31204-1474
Phone (478) 361-2822

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20131002000704 GA Practitioner - Physical Medicine and Rehabilitation 6507002250 Reassigns benefits to 3 organizations
Practice locations: Macon, GA

Care Compare profile

Medicare Care Compare
Specialty
Physical Medicine and Rehabilitation
Education
Medical College of Georgia School of Medicine, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Health Services of Central GeorgiaGroup PAC ID 9638076730, 300 clinicians
Central Georgia RehabilitationGroup PAC ID 7012914310, 10 clinicians

Practice addresses (Care Compare)

1120 Morningside Dr
Perry, GA 31069-2906
Phone (478) 987-3600

3351 Northside Dr
Macon, GA 31210-2587
Phone (478) 201-6500

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Optimus Diagnostics LLC Current Accepting new patients
Health Services of Central Georgia, Inc CurrentSince Jun 1, 2024 Accepting new patients
Community Primary Care of Georgia LLC CurrentSince Feb 3, 2020 Accepting new patients
Affinis Hospice, LLC PastSince Nov 9, 2020 Accepting new patients

Locations

1005 Boulder Dr
Gray, GA 31032
Phone (478) 621-2072

3351 Northside Dr
Macon, GA 31210
Phone (478) 201-6500

4035 Elnora Dr
Macon, GA 31210
Phone (478) 201-6500

1120 Morningside Dr
Perry, GA 31069
Phone (478) 218-1706

Organizations & group practices 6

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.

Hospital & facility affiliations 5

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": "1240963200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1489363200000",
    "number": "1346484763",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3022 CASTLEWOODS DR",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312041474",
            "telephone_number": "478-361-2822"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3351 NORTHSIDE DR",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312102587",
            "telephone_number": "478-201-6500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARSHALL",
        "first_name": "TRISTA",
        "middle_name": "JACINTA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-04-29",
        "last_updated": "2017-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "GA",
            "license": "068927",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Macon, GA

Sources for this page

Verify at the official NPI Registry.