Individual provider Active NPI

Rebecca Holly Marshall, M.D.

  • Internal Medicine Physician
  • St Petersburg, FL
National Provider Identifier
1649266099
Registry record updated Mar 4, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME57714 Issued in FL
Practice address
620 10TH Street N.
St Petersburg, FL 33705-1407
Phone
(727) 824-8330
Fax
(727) 824-8215
NPI assigned
Sep 21, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X ME57714 FL Primary

Addresses

Primary practice location

620 10TH Street N.
St Petersburg, FL 33705-1407

Mailing address

PO Box 12868
St Petersburg, FL 33733-2868
Phone (727) 824-8294

Other identifiers 1

IdentifierTypeStateIssuer
063511100MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20100920000300 FL Practitioner - Internal Medicine 3577587583 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Baycare Medical Group, Inc. Internal Medicine CurrentSince Jan 1, 2019 Accepting new patients
Baycare Medical Group, Inc. CurrentSince Jan 1, 2019 Accepting new patients
Baycare Medical Group Pediatric Walk-in Care LLC Past Accepting new patients
Baycare Medical Group Pediatric Walk-in, LLC Past Accepting new patients
Suncoast Medical Clinic LLC Past Accepting new patients
Suncoast Medical Clinic LLC Past Accepting new patients
Suncoast Medical Clinic LLC Past Accepting new patients

Locations

2995 Drew St
Fl 2
Clearwater, FL 33759
Phone (727) 315-7234

2461 Enterprise Rd
Ste C
Clearwater, FL 33763
Phone (727) 725-5060

12450 Roosevelt Blvd N
Ste 308
St Petersburg, FL 33716
Phone (727) 572-0900

620 10th St N
Ste 1E
St Petersburg, FL 33705
Phone (727) 824-3120

Interoperability endpoints

  • Direct secure messaging: rebeccah.marshall@direct.mybaycare.org

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1127260800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1457049600000",
    "number": "1649266099",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 12868",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337332868",
            "telephone_number": "727-824-8294",
            "fax_number": "727-824-3132"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "620 10TH STREET N.",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337051407",
            "telephone_number": "727-824-8330",
            "fax_number": "727-824-8215"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARSHALL",
        "first_name": "REBECCA",
        "middle_name": "HOLLY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-09-21",
        "last_updated": "2016-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME57714",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "063511100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in St Petersburg, FL

Sources for this page

Verify at the official NPI Registry.