Mallory Enzor Marshall

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

LL86290 Issued in SC

Practice address

Prisma Health Children's Hospital Outpatient Center
14 Medical Park, Suite 400
Columbia, SC 29203

Phone

(893) 434-6155

Fax

(803) 434-6979

NPI assigned

May 19, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AL

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: melanie.marshall.p1@direct.umc.nextgenshare.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.

• Capstone Health Services Foundation PC

  dba University Medical Center

  • Family Medicine Physician
  • Tuscaloosa, AL
  • NPI 1740397751
  Medicare reassignment NPD
• The DCH Healthcare Authority

  dba DCH Regional Medical Center

  • General Acute Care Hospital
  • Tuscaloosa, AL
  • NPI 1841394418
  Medicare reassignment NPD
• Capstone Health Services Foundation PC

  dba University Medical Center Neurology

  • Neurology Physician
  • Tuscaloosa, AL
  • NPI 1255212353
  NPD
• The DCH Health Care Authority

  dba DCH Health & Wellness Clinic

  • Clinic/Center
  • Tuscaloosa, AL
  • NPI 1306613211
  NPD
• DCH Provider Services, LLC

  dba DCH Pediatric Hospitalists

  • Hospitalist Physician
  • Tuscaloosa, AL
  • NPI 1104117068
  NPD (past)

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

{
    "created_epoch": "1621382400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627862400000",
    "number": "1639743081",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PRISMA HEALTH CHILDREN'S HOSPITAL OUTPATIENT CENTER",
            "address_2": "14 MEDICAL PARK, SUITE 400",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "29203",
            "telephone_number": "893-434-6155",
            "fax_number": "803-434-6979"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "PRISMA HEALTH CHILDREN'S HOSPITAL OUTPATIENT CENTER",
            "address_2": "14 MEDICAL PARK, SUITE 400",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "29203",
            "telephone_number": "893-434-6155",
            "fax_number": "803-434-6979"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARSHALL",
        "first_name": "MALLORY",
        "middle_name": "ENZOR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-05-19",
        "last_updated": "2021-08-02",
        "certification_date": "2021-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "SC",
            "license": "LL86290",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• John David Marsh, RPH
• Kimberly Latisha Marsh
• Thomas David Marsh, MD
• Amber T Marshall, MD
• Catherine Iris Marshall, APRN
• Margaret Marshall
• Mileka Marshall, PHARM D
• Scott Craig Marshall, D.M.D.
• Erica Siovhan Marshburn, M.D.
• Sherry Beth Martell

• Pediatrics Physician in Columbia, SC
• Providers in Columbia, SC by specialty
• Pediatrics Physician in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2021; 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.