Russell Gordon Marquardt Sr., PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

888 Issued in IA

Practice address

1220 Chatburn Ave
Harlan, IA 51537-2009

Phone

(712) 755-5130

Fax

(712) 755-4445

NPI assigned

Jul 12, 2005

Last updated

Dec 4, 2007By 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 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IA

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

Specialty

Physician Assistant

Education

Other, 1983

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Shelby County Chris a Myrtue Memorial HospitalGroup PAC ID 5193619393, shared by 12 NPIs, 49 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Myrtue Medical Center Hospital, Harlan, IA, CCN 161374

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: rmarquardt1063991@direct.unitypoint.org
• Direct secure messaging: rmarquardt117881@uihcdirect.org

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.

• Shelby County Chris a Myrtue Memorial Hospital

  dba Myrtue Medical Center

  • Critical Access Hospital
  • Harlan, IA
  • NPI 1598871469
  Medicare reassignment NPD
• Shelby County Chris a. Myrtue Memorial Hospital

  dba Myrtue Medical Center

  • Family Medicine Physician
  • Harlan, IA
  • NPI 1922184175
  Medicare reassignment NPD
• Signify Health Medical Associates, PLLC

  • General Practice Physician
  • Dallas, TX
  • NPI 1750845863

  IA

  Medicare reassignment NPD
• Theoria Medical

  • Internal Medicine Physician
  • Novi, MI
  • NPI 1609362375

  IA

  Medicare reassignment
• St Luke's Methodist Hospital

  • General Acute Care Hospital
  • Cedar Rapids, IA
  • NPI 1083708226
  NPD

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

• Shelby County Chris a Myrtue Memorial Hospital

  dba Myrtue Medical Center

  • Critical Access Hospital
  • Harlan, IA
  • NPI 1598871469
  Care Compare affiliation

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

{
    "created_epoch": "1121126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1196726400000",
    "number": "1477551661",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4022 MAIN ST",
            "city": "ELK HORN",
            "state": "IA",
            "postal_code": "51531",
            "telephone_number": "712-764-4642",
            "fax_number": "712-764-4643"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1220 CHATBURN AVE",
            "city": "HARLAN",
            "state": "IA",
            "postal_code": "515372009",
            "telephone_number": "712-755-5130",
            "fax_number": "712-755-4445"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARQUARDT",
        "first_name": "RUSSELL",
        "middle_name": "GORDON",
        "name_prefix": "Mr.",
        "name_suffix": "Sr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-12",
        "last_updated": "2007-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "IA",
            "license": "888",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Wendy Jo Leinen, PTA
• Living Well Home Care LLC (Living Well Home Care)
• Markham Family Dental Associates, Inc.
• Phillip Lynn Markham, DDS
• Scott A Markham, D.O.
• Howard Henry McCutchan, O.D.
• Medivac Corp
• Deborah Lynn Meissner, LCSW, LIMHP, LADC
• Shelly L Menard, APRN
• Kristi Marie Merchant, OD

• Medical Physician Assistant in Harlan, IA
• Providers in Harlan, IA by specialty
• Medical Physician Assistant in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2007; 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.