Marshal T Gwynn, DPM

Primary specialty

PodiatristTaxonomy code 213E00000X

License

0103301085 Issued in VA

Practice address

401 Rogers St
Princeton, WV 24740-3636

Phone

(304) 487-9442

Fax

(330) 536-0069

NPI assigned

Apr 23, 2010

Last updated

Jun 9, 2020By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in VA, WV2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Specialty

Podiatry

Education

Kent State University College of Podiatric Medicine, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Foot and Ankle Clinic of the Virginias IncGroup PAC ID 7911948583, 12 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Princeton Community Hospital Assn Inc Hospital, Princeton, WV, CCN 510046

Merit-based Incentive Payment System (MIPS)

Final score

75 of 100Reported as group

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: marshalgwynn@footclinic.allscriptsdirect.net

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.

• Foot and Ankle Clinic of the Virginias Inc

  • Podiatrist
  • Princeton, WV
  • NPI 1740227909

  VA

  Medicare reassignment Care Compare group NPD
• Foot and Ankle Clinic of the Virginias Inc

  • Podiatrist
  • Fayetteville, WV
  • NPI 1093678922
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Princeton Community Hospital Assn., Inc.

  • General Acute Care Hospital
  • Princeton, WV
  • NPI 1558313213
  Care Compare affiliation

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

{
    "created_epoch": "1271980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1591660800000",
    "number": "1407173982",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 365",
            "city": "PROSPERITY",
            "state": "WV",
            "postal_code": "259090365",
            "telephone_number": "304-487-9442",
            "fax_number": "330-542-9932"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 ROGERS ST",
            "city": "PRINCETON",
            "state": "WV",
            "postal_code": "247403636",
            "telephone_number": "304-487-9442",
            "fax_number": "330-536-0069"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GWYNN",
        "first_name": "MARSHAL",
        "middle_name": "T",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-04-23",
        "last_updated": "2020-06-09",
        "certification_date": "2020-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "WV",
            "license": "10436",
            "primary": false
        },
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "VA",
            "license": "0103301085",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE NUMBER",
            "identifier": "VVA226A",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Nola Glenora Gum, MSW, LCSW
• Kasey Leeann Gunnoe
• Marcia Gurganus, R.PH.
• Aliyah Gwinn
• Meredith Kay Gwinn
• Melissa Hager
• Jennifer Hagerman
• Scotty Hagerman, LGSW, LMSW
• Hair Studio and Day Spa, Inc
• Amy Hale

• Podiatrist in Princeton, WV
• Providers in Princeton, WV by specialty
• Podiatrist in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.