Diana K. Marshall, P.A.

Individual provider Active NPI Medical Physician Assistant · Columbus, KS

NPI 1376586891 · NPPES record last updated Feb 10, 2012

Key facts

NPI
1376586891
Entity type
Individual (NPI type 1)
Primary specialty
Medical Physician Assistant 363AM0700X
License
15-00487 (KS)
Practice address
101 W Sycamore St
Columbus, KS 66725-1276
Phone
(620) 429-3636
Fax
(620) 429-1301
NPI assigned
Jun 13, 2006
Sex
Female
Sole proprietor
No

Organizations & group practices 2

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.

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
15-00487KSMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Sjmgroup Past Accepting new patients
St. John'S Medical Group Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: dmarshall190106@directb.mercy.net

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 15-00487 KS Yes

Addresses

Primary practice location

101 W Sycamore St
Columbus, KS 66725-1276

Mailing address

101 W Sycamore St
Columbus, KS 66725-1276
Phone (620) 429-3636

Other identifiers

IdentifierTypeStateIssuer
1376586891OtherKSBLUE CROSS
100349810HMedicaidKS

Other providers in Columbus, KS

All providers in Columbus, KS · Medical Physician Assistant in Kansas

Sources for this page

Verify at the official NPI Registry.