Organization Active NPI

Dr J J Marsh LTD

  • Optometrist
  • Oshkosh, WI
National Provider Identifier
1366552663
Registry record updated Apr 26, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2161 Issued in WI
Legal business name
DR J J MARSH LTD
Practice address
2510 W. 9TH Ave
Oshkosh, WI 54904-4907
Phone
(920) 426-2020
Fax
(920) 235-3195
NPI assigned
Aug 30, 2006
Last updated
Apr 26, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 26, 2017

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

Authorized official

Name
Dr. Jeffrey J. Marsh, O.D.NPI 1902884489
Title
Optometrist/Owner
Phone
(920) 426-2020

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2161 WI Primary

Addresses

Primary practice location

2510 W. 9TH Ave
Oshkosh, WI 54904-4907

Mailing address

2510 W. 9TH Ave
Oshkosh, WI 54904-4907
Phone (920) 426-2020

Other identifiers 2

IdentifierTypeStateIssuer
2161OtherWISTATE LICENSE
38529700MedicaidWI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20061114000203 WI Part B Supplier - Clinic/Group Practice 9234137902 Receives reassigned benefits from 3 practitioners
Practice locations: Oshkosh, WI; Winneconne, WI
O20100930090175 WI DME Supplier - Physician - Optometrist 9234137902 Practice locations: Oshkosh, WI

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Dr J J Marsh LTD2510 W 9TH Ave, Oshkosh, WI 54904-8125(920) 426-2020 Prosthetic Lenses: Conventional Eyeglasses|Prosthetic Lenses: Conventional Contact Lenses Accepts assignmentParticipating since Dec 1, 2006

National Provider Directory

National Provider Directory

Locations

2510 W 9th Ave
Oshkosh, WI 54904
Phone (920) 426-2020

423 N Main St
Oshkosh, WI 54901
Phone (920) 426-2020

908 E Main St
Ste A
Winneconne, WI 54986
Phone (920) 528-4477

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1493164800000",
    "number": "1366552663",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2510 W. 9TH AVE",
            "city": "OSHKOSH",
            "state": "WI",
            "postal_code": "549044907",
            "telephone_number": "920-426-2020",
            "fax_number": "920-235-3195"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2510 W. 9TH AVE",
            "city": "OSHKOSH",
            "state": "WI",
            "postal_code": "549044907",
            "telephone_number": "920-426-2020",
            "fax_number": "920-235-3195"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR J J MARSH LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-30",
        "last_updated": "2017-04-26",
        "status": "A",
        "authorized_official_last_name": "MARSH",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "J.",
        "authorized_official_title_or_position": "OPTOMETRIST/OWNER",
        "authorized_official_telephone_number": "920-426-2020",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WI",
            "license": "2161",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "2161",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "38529700",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oshkosh, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.