Individual provider Active NPI

Marshall L Chambliss, MD

  • Family Medicine Physician
  • Greensboro, NC
National Provider Identifier
1629026471
Registry record updated Sep 24, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
9600329 Issued in NC
Practice address
1125 N Church St
Greensboro, NC 27401-1007
Phone
(336) 832-8035
NPI assigned
May 4, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 9600329 NC Primary

Addresses

Primary practice location

1125 N Church St
Greensboro, NC 27401-1007

Mailing address

1125 N Church St
Greensboro, NC 27401-1007
Phone (336) 832-8035

Other identifiers 5

IdentifierTypeStateIssuer
4308504OtherNCAETNA
21961OtherNCBCBSNC
8921961MedicaidNC
14725OtherNCPARTNERS MEDICARE
64949OtherNCMEDCOST

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mchambliss9644@direct.conehealth.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080325000696 NC Practitioner - Family PracticePractitioner - General Practice 5294811659 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Virginia School of Medicine, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1125 N Church St
Greensboro, NC 27401-1007
Phone (336) 832-8035

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
The Moses H Cone Memorial Hospital Operating Corporation CurrentSince Jan 1, 2025 Accepting new patients
The Moses H Cone Memorial Hospital Operating Corporation Family Medicine CurrentSince Jan 1, 2025 Accepting new patients

Locations

700 Walter Reed Dr
Greensboro, NC 27403
Phone (336) 832-9600

201 E Wendover Ave
Greensboro, NC 27401
Phone (336) 275-6318

1125 N Church St
Greensboro, NC 27401
Phone (336) 832-8035

1131 N Church St
Greensboro, NC 27401
Phone (336) 358-5100

1200 N Elm St
Greensboro, NC 27401
Phone (336) 574-7000

Interoperability endpoints

  • Direct secure messaging: mchambliss9644@direct.conehealth.com

Organizations & group practices 2

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1146700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632441600000",
    "number": "1629026471",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1125 N CHURCH ST",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274011007",
            "telephone_number": "336-832-8035"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1125 N CHURCH ST",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274011007",
            "telephone_number": "336-832-8035"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAMBLISS",
        "first_name": "MARSHALL",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-04",
        "last_updated": "2021-09-24",
        "certification_date": "2021-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "9600329",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "4308504",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSNC",
            "identifier": "21961",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8921961",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PARTNERS MEDICARE",
            "identifier": "14725",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDCOST",
            "identifier": "64949",
            "state": "NC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mchambliss9644@direct.conehealth.com",
            "affiliation": "N",
            "endpointDescription": "Cone Health Direct Message",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1125 N Church St",
            "city": "Greensboro",
            "state": "NC",
            "country_code": "US",
            "postal_code": "274011007",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Greensboro, NC

Sources for this page

Verify at the official NPI Registry.