Olivia Marie Marshall, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

6570 Issued in AZ

Practice address

900 E Washington St Ste 200
Colton, CA 92324-4192

Phone

(909) 882-5867

Fax

(909) 503-1913

NPI assigned

Jul 13, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other names 1

• Mrs. Olivia Marie Marshall Professional name

Medicare fee-for-service enrollment

Enrolled in AZ

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: olivia.marshall@1174.chartlogic.direct-ci.com

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.

• VHS Outpatient Clinics, Inc.

  dba Abrazo Medical Group

  • Multi-Specialty Clinic/Center
  • Goodyear, AZ
  • NPI 1912979964
  Medicare reassignment NPD

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

{
    "created_epoch": "1468368000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1555891200000",
    "number": "1639522766",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "399 E 21ST ST",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924044815",
            "telephone_number": "909-882-5867",
            "fax_number": "909-803-1923"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 E WASHINGTON ST STE 200",
            "city": "COLTON",
            "state": "CA",
            "postal_code": "923244192",
            "telephone_number": "909-882-5867",
            "fax_number": "909-503-1913"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3811 E Bell Rd Ste 107",
            "address_purpose": "LOCATION",
            "city": "Phoenix",
            "state": "AZ",
            "postal_code": "850322158",
            "country_code": "US",
            "telephone_number": "602-482-6100",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6950 E Chauncey Ln",
            "address_purpose": "LOCATION",
            "city": "Phoenix",
            "state": "AZ",
            "postal_code": "850545178",
            "country_code": "US",
            "telephone_number": "623-873-8565",
            "fax_number": "480-372-2110",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MARSHALL",
        "first_name": "OLIVIA",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-07-13",
        "last_updated": "2019-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "55316",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": "6570",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "OLIVIA",
            "last_name": "MARSHALL",
            "middle_name": "MARIE",
            "prefix": "MRS.",
            "credential": "PA",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Mitchell Espanola Marquez
• David Randall Marquis, COUNSELOR
• Sara Naomi Marrero Hernandez
• Olga Marrero
• Lorena Marshall
• Belissa Martin
• Carrie Martin, OTR
• David Evan Martin, MA LPC, LPCC
• Paula Martin
• Scott Luis Martin, PA

• Physician Assistant in Colton, CA
• Providers in Colton, CA by specialty
• Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.