Individual provider Active NPI

Gary Marshall, DPH

  • Pharmacist
  • Columbia, TN
National Provider Identifier
1366729188
Registry record updated Nov 8, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
TN8089 Issued in TN
Practice address
1202 S James Campbell Blvd
Columbia, TN 38401-5193
Phone
(631) 380-0599
Fax
(931) 380-3039
NPI assigned
Nov 8, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 8, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X TN8089 TN Primary

Addresses

Primary practice location

1202 S James Campbell Blvd
Columbia, TN 38401-5193

Mailing address

1202 S James Campbell Blvd
Columbia, TN 38401-5193
Phone (631) 380-0599

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
TN8089TNMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1320710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1320710400000",
    "number": "1366729188",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1202 S JAMES CAMPBELL BLVD",
            "city": "COLUMBIA",
            "state": "TN",
            "postal_code": "384015193",
            "telephone_number": "631-380-0599",
            "fax_number": "931-380-3039"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1202 S JAMES CAMPBELL BLVD",
            "city": "COLUMBIA",
            "state": "TN",
            "postal_code": "384015193",
            "telephone_number": "631-380-0599",
            "fax_number": "931-380-3039"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARSHALL",
        "first_name": "GARY",
        "credential": "DPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-11-08",
        "last_updated": "2011-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "TN",
            "license": "TN8089",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2011; 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.