Individual provider Active NPI

Ken K Marshall, PHARM D

  • Pharmacist
  • Charlottesville, VA
National Provider Identifier
1578285169
Registry record updated Sep 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
0202220761 Issued in VA
Practice address
1980 Rio Hill Ctr
Charlottesville, VA 22901-1144
Phone
(434) 978-1311
NPI assigned
Sep 12, 2022
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 12, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 0202220761 VA Primary

Addresses

Primary practice location

1980 Rio Hill Ctr
Charlottesville, VA 22901-1144

Mailing address

2907 Idlewood Dr
Charlottesville, VA 22901-1123
Phone (434) 466-5273

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
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
0202220761VAMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1662940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662940800000",
    "number": "1578285169",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2907 IDLEWOOD DR",
            "city": "CHARLOTTESVILLE",
            "state": "VA",
            "postal_code": "229011123",
            "telephone_number": "434-466-5273"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1980 RIO HILL CTR",
            "city": "CHARLOTTESVILLE",
            "state": "VA",
            "postal_code": "229011144",
            "telephone_number": "434-978-1311"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARSHALL",
        "first_name": "KEN",
        "middle_name": "K",
        "credential": "PHARM D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-09-12",
        "last_updated": "2022-09-12",
        "certification_date": "2022-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "VA",
            "license": "0202220761",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlottesville, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2022; 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.