Active NPI
Brent A. Marshall, MS, ATC, CES
- Athletic Trainer
- Portland, OR
National Provider Identifier
1477956571
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- AT-AT-10165211
- Practice address
- 2900 NE 132ND Ave
Portland, OR 97230-3014 - Phone
- (503) 847-2546
- NPI assigned
- Oct 2, 2014
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | AT-AT-10165211 | OR | Primary |
| Athletic Trainer | 2255A2300X | 9042194-4810 | UT |
Addresses
Primary practice location
2900 NE 132ND Ave
Portland, OR 97230-3014
Mailing address
2900 NE 132ND Ave
Portland, OR 97230-3014
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
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| AT-AT-10165211 | OR | MD | Athletic Trainer |
| 9042194-4810 | UT | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1412208000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1492387200000",
"number": "1477956571",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2900 NE 132ND AVE",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972303014"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2900 NE 132ND AVE",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972303014",
"telephone_number": "503-847-2546"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARSHALL",
"first_name": "BRENT",
"middle_name": "A.",
"credential": "MS, ATC, CES",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2014-10-02",
"last_updated": "2017-04-17",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "OR",
"license": "AT-AT-10165211",
"primary": true
},
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "UT",
"license": "9042194-4810",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Portland, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.