Individual provider Active NPI

Eric Douglas Marshall, CRNP

  • Acute Care Nurse Practitioner
  • Mobile, AL
National Provider Identifier
1417654062
Registry record updated Feb 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
1-153796 Issued in AL
Practice address
1720 Spring Hill Ave Ste 301
Mobile, AL 36604-1409
Phone
(251) 435-2663
NPI assigned
Feb 14, 2023
Last updated
Feb 19, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 19, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 1-153796 AL Primary

Addresses

Primary practice location

1720 Spring Hill Ave Ste 301
Mobile, AL 36604-1409

Mailing address

2704 Riverside Dr
Mobile, AL 36605-4133
Phone (205) 420-9515

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230404002668 AL Practitioner - Nurse Practitioner 3476928458 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of South Alabama College of Medicine, 2022
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1720 Spring Hill Ave
FL 3
Mobile, AL 36604-1406

1725 Spring Hill Ave
Mobile, AL 36604-1402

2704 Riverside Dr
Mobile, AL 36605-4133

PO Box
Suite 393
Seekonk, MA 02771-0393

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Southern Orthopaedic Alliance PLLC CurrentSince Oct 1, 2023 Accepting new patients
Imc -Gulf Orthopaedics LLC CurrentSince Mar 21, 2023 Accepting new patients
Southern Orthopaedic Alliance, PLLC CurrentSince Oct 1, 2023 Accepting new patients
Imc -Gulf Orthopaedics LLC CurrentSince Mar 21, 2023 Accepting new patients

Locations

341 Greeno Rd N
Fairhope, AL 36532
Phone (251) 210-1320

1720 Spring Hill Ave
Fl 3
Mobile, AL 36604
Phone (251) 435-1164

1720 Spring Hill Ave
Ste 3
Mobile, AL 36604

831 Hillcrest Rd
Mobile, AL 36695
Phone (251) 633-4949

Interoperability endpoints

  • Direct secure messaging: emarshall122325@directinfirmaryhealth.org

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1676332800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708300800000",
    "number": "1417654062",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2704 RIVERSIDE DR",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366054133",
            "telephone_number": "205-420-9515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1720 SPRING HILL AVE STE 301",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366041409",
            "telephone_number": "251-435-2663"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARSHALL",
        "first_name": "ERIC",
        "middle_name": "DOUGLAS",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-02-14",
        "last_updated": "2024-02-19",
        "certification_date": "2024-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "AL",
            "license": "1-153796",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mobile, AL

Sources for this page

Verify at the official NPI Registry.