Individual provider Active NPI

Sharon Philippa Marshall, MD

  • Pediatric Adolescent Medicine Physician
  • Detroit, MI
National Provider Identifier
1659319770
Registry record updated Jan 13, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Adolescent Medicine PhysicianTaxonomy code 2080A0000X
License
4301406543 Issued in MI
Practice address
3950 Beaubien
Children'S Hospital of Mi
Detroit, MI 48201
Phone
(313) 832-8290
Fax
(313) 993-0081
NPI assigned
Jun 2, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 13, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 4301406543 MI
Pediatric Adolescent Medicine Physician 2080A0000X 4301406543 MI Primary

Addresses

Primary practice location

3950 Beaubien
Children'S Hospital of Mi
Detroit, MI 48201

Mailing address

4201 St. Antoine - Uhc 5D Mailbox 226
University Pediatricians
Detroit, MI 48201-2061
Phone (313) 745-4405

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20100917000686 MI Practitioner - Pediatric Medicine 8729103486 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pediatric Medicine
Education
Missouri Medical College, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wayne Pediatrics, IncGroup PAC ID 4486062122, 3 clinicians

Practice addresses (Care Compare)

400 Mack Ave
Suite 1
Detroit, MI 48201-2136
Phone (313) 448-9600

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301406543MIMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Wayne Pediatrics Inc. Pediatrics CurrentSince Feb 23, 2021 Accepting new patients
University Pediatricians Pediatrics CurrentSince Aug 30, 2010 Accepting new patients
University Pediatricians Pediatrics CurrentSince Aug 30, 2010 Accepting new patients
Resilience Healthcare - Lakefront Medical Associates, LLC PastSince Feb 23, 2021 Accepting new patients

Locations

3901 Beaubien St
Detroit, MI 48201
Phone (313) 745-5227

400 Mack Ave
Ste 1
Detroit, MI 48201
Phone (313) 448-9600

3950 Beaubien St
Detroit, MI 48201
Phone (313) 745-5437

400 Mack Ave
Ste 9
Detroit, MI 48201

Interoperability endpoints

  • Direct secure messaging: smarshal@direct.dmc.org
  • Direct secure messaging: smarshall681950@direct.hfhs.org

Organizations & group practices 4

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": "1149206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1484265600000",
    "number": "1659319770",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4201 ST. ANTOINE - UHC 5D MAILBOX 226",
            "address_2": "UNIVERSITY PEDIATRICIANS",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482012061",
            "telephone_number": "313-745-4405",
            "fax_number": "313-966-0665"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3950 BEAUBIEN",
            "address_2": "CHILDREN'S HOSPITAL OF MI",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "48201",
            "telephone_number": "313-832-8290",
            "fax_number": "313-993-0081"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARSHALL",
        "first_name": "SHARON",
        "middle_name": "PHILIPPA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-02",
        "last_updated": "2017-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MI",
            "license": "4301406543",
            "primary": false
        },
        {
            "code": "2080A0000X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": "MI",
            "license": "4301406543",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

Verify at the official NPI Registry.