Individual provider Active NPI

Tracy Jones Marshall, LPN

  • Licensed Practical Nurse
  • Warner Robins, GA
National Provider Identifier
1538313101
Registry record updated Nov 10, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
056838 Issued in GA
Practice address
940 Highway 96 Ste a
Warner Robins, GA 31088-2587
Phone
(478) 988-1222
Fax
(478) 988-1241
NPI assigned
Nov 10, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 10, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 056838 GA Primary

Addresses

Primary practice location

940 Highway 96 Ste a
Warner Robins, GA 31088-2587

Mailing address

219 Bluebird LN
Perry, GA 31069-9389
Phone (478) 988-1222

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

State licenses

LicenseStateTypeSpecialty
056838GAMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1226275200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1226275200000",
    "number": "1538313101",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "219 BLUEBIRD LN",
            "city": "PERRY",
            "state": "GA",
            "postal_code": "310699389",
            "telephone_number": "478-988-1222",
            "fax_number": "478-988-1241"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "940 HIGHWAY 96 STE A",
            "city": "WARNER ROBINS",
            "state": "GA",
            "postal_code": "310882587",
            "telephone_number": "478-988-1222",
            "fax_number": "478-988-1241"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARSHALL",
        "first_name": "TRACY",
        "middle_name": "JONES",
        "name_prefix": "Ms.",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-11-10",
        "last_updated": "2008-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "GA",
            "license": "056838",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Warner Robins, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 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.