Active NPI
Bret D Marshall, M.D.
- Psychiatry Physician
- Woods Cross, UT
National Provider Identifier
1649332115
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 181242-1205
- Practice address
- 592 W 1350 S
Woods Cross, UT 84010-8180 - Phone
- (801) 299-5300
- Fax
- (801) 606-0671
- NPI assigned
- Dec 14, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 181242-1205 | UT | Primary |
Addresses
Primary practice location
592 W 1350 S
Woods Cross, UT 84010-8180
Mailing address
592 W 1350 S
Woods Cross, UT 84010-8180
Phone (801) 299-5300
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1032210010 | Medicaid | AK | |
| 9118124 | Medicaid | OK | |
| F31605 | Medicaid | NV |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 181242-1205 | UT | MD | Psychiatry Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kids Behavioral Health of Utah, Inc | Past | Accepting new patients | |
| Benchmark Behavioral Health System Inc | Past | Accepting new patients |
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.
-
- Psychiatric Residential Treatment Facility
- Woods Cross, UT
- NPI 1598772618
-
- Emotionally Disturbed Childrens' Residential Treatment Facility
- West Jordan, UT
- NPI 1649380593
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1166054400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1649332115",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "592 W 1350 S",
"city": "WOODS CROSS",
"state": "UT",
"postal_code": "840108180",
"telephone_number": "801-299-5300",
"fax_number": "801-606-0671"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "592 W 1350 S",
"city": "WOODS CROSS",
"state": "UT",
"postal_code": "840108180",
"telephone_number": "801-299-5300",
"fax_number": "801-606-0671"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARSHALL",
"first_name": "BRET",
"middle_name": "D",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-12-14",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "UT",
"license": "181242-1205",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1032210010",
"state": "AK"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "9118124",
"state": "OK"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "F31605",
"state": "NV"
}
],
"endpoints": [],
"other_names": []
}Other providers in Woods Cross, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.