NPIMap

Organization Active NPI

Marshall Medical Center

Doing business as Marshall Psychiatry

  • Adult Mental Health Clinic/Center
  • Cameron Park, CA
National Provider Identifier
1356904577
Registry record updated Apr 15, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X
Legal business name
MARSHALL MEDICAL CENTER
Doing business as
Marshall Psychiatry
Practice address
3581 Palmer Dr Ste 202
Cameron Park, CA 95682-8237
Phone
(530) 672-7000
NPI assigned
Apr 15, 2019
Last updated
Apr 15, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 15, 2019

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

Authorized official

Name
Kim Sanguinetti-Weishaar
Title
Provider Credentialing
Phone
(530) 626-2770

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Mental Health Clinic/Center 261QM0850X Primary
Adolescent and Children Mental Health Clinic/Center 261QM0855X

Addresses

Primary practice location

3581 Palmer Dr Ste 202
Cameron Park, CA 95682-8237

Mailing address

PO Box 45680
San Francisco, CA 94145-0680
Phone (530) 626-2618

Other names 1

  • Marshall Psychiatry Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031208001095 CA Part B Supplier - Clinic/Group Practice 7517875859 Receives reassigned benefits from 169 practitioners
14 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Placerville, CA; Twin Bridges, CA; Gold River, CA; El Dorado Hills, CA; Cameron Park, CA

Other NPIs on the same Medicare enrollment 14

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 14

National Provider Directory

National Provider Directory
Tax ID family
Marshall Hosp Pul Funct18 organizations share this tax ID, including this one

Other organizations with this tax ID 17

Organizations that report the same tax identification number in the National Provider Directory.

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1555286400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1555286400000",
    "number": "1356904577",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 45680",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941450680",
            "telephone_number": "530-626-2618"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3581 PALMER DR STE 202",
            "city": "CAMERON PARK",
            "state": "CA",
            "postal_code": "956828237",
            "telephone_number": "530-672-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARSHALL MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-04-15",
        "last_updated": "2019-04-15",
        "status": "A",
        "authorized_official_last_name": "SANGUINETTI-WEISHAAR",
        "authorized_official_first_name": "KIM",
        "authorized_official_title_or_position": "PROVIDER CREDENTIALING",
        "authorized_official_telephone_number": "530-626-2770"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Marshall Psychiatry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Cameron Park, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.