David Keith Marcoux, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

50001064 Issued in OH

Practice address

600 Casson Hill Rd
Fort Riley, KS 66442-7037

Phone

(785) 239-7155

Fax

(740) 687-9059

NPI assigned

May 3, 2007

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

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.

• Observation Medicine Physicians of Champaign County, LTD

  • Emergency Medicine Physician
  • Springfield, OH
  • NPI 1164839726
  NPD (past)

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

{
    "created_epoch": "1178150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1212451200000",
    "number": "1497977607",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 CASSON HILL RD",
            "city": "FORT RILEY",
            "state": "KS",
            "postal_code": "664427037",
            "telephone_number": "785-239-7155",
            "fax_number": "740-687-9059"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 CASSON HILL RD",
            "city": "FORT RILEY",
            "state": "KS",
            "postal_code": "664427037",
            "telephone_number": "785-239-7155",
            "fax_number": "740-687-9059"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARCOUX",
        "first_name": "DAVID",
        "middle_name": "KEITH",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-03",
        "last_updated": "2008-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "OH",
            "license": "50001064",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OHIO PA MEDICAL LICENSE",
            "identifier": "50001064",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Aubrey Janae Maggard, RDN
• Austin T Majure, DDS
• Sandeep Manandhar, PA-C
• Melissa Ann Marcelli-Flint, LCSW
• Joseph M Marcotte, DPT, ATC, CSCS
• Drew J. Marr, PAC
• Daniel Martin, LSCSW
• Heidi Martinez, PH.D.
• Robert Martinusek, PT
• Dallas Tristan Mason, PA

• Medical Physician Assistant in Fort Riley, KS
• Providers in Fort Riley, KS by specialty
• Medical Physician Assistant in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.