Scott Lee Marshall, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

070010488 Issued in IL

Practice address

1440 W Walnut St
#2
Jacksonville, IL 62650-1143

Phone

(217) 245-1455

Fax

(217) 243-6903

NPI assigned

Jan 11, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Washington University School of Medicine, 1997

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Beardstown Therapy ClinicGroup PAC ID 6507223989, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Beardstown Therapy Clinic

  • Physical Therapist
  • Beardstown, IL
  • NPI 1700596442
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1136937600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1216166400000",
    "number": "1649259342",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1440 W WALNUT ST",
            "address_2": "#2",
            "city": "JACKSONVILLE",
            "state": "IL",
            "postal_code": "626501143",
            "telephone_number": "217-245-1455",
            "fax_number": "217-243-6903"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1440 W WALNUT ST",
            "address_2": "#2",
            "city": "JACKSONVILLE",
            "state": "IL",
            "postal_code": "626501143",
            "telephone_number": "217-245-1455",
            "fax_number": "217-243-6903"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARSHALL",
        "first_name": "SCOTT",
        "middle_name": "LEE",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-11",
        "last_updated": "2008-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070010488",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DMERC NPI",
            "identifier": "1083769475",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP PTAN",
            "identifier": "216653",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "0005415281",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Stephanie Lee Mabus
• Madhusudan Vallala M.D., S.C.
• Natalie Mahoney
• John L. Malcott, M.D.
• Michael Scott Markley, M.D.
• James Nicholas Martin, D.C
• Edwin Roy Mathews, DO
• Kable May, PA
• MBRX Inc
• Kayla Danielle McClusky

• Physical Therapist in Jacksonville, IL
• Providers in Jacksonville, IL by specialty
• Physical Therapist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.