Christopher D Marshall MD PLLC

Primary specialty

Rural Health Clinic/CenterTaxonomy code 261QR1300X

Legal business name

CHRISTOPHER D MARSHALL MD PLLC

Doing business as

Christopher D Marshall MD PLLC
Medical Specialty Clinic

Practice address

190 University Ave
Parsons, TN 38363-2972

Phone

(731) 845-3813

Fax

(731) 257-1501

NPI assigned

Feb 17, 2015

Last updated

Oct 16, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Christopher Dean Averett Marshall, MDNPI 1144425075

Title

Ceo

Phone

(731) 257-1500

Specialties & licenses 8

Addresses

Other names 2

• CHRISTOPHER D MARSHALL MD PLLC Doing business as
• Medical Specialty Clinic Doing business as

Medicare fee-for-service enrollment

Enrolled in TN2 enrollments

Enrollment records 2

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1659762391. Details of each certification follow.

• CCN 883964 Rural health clinic · Active · Details

Rural health clinic certification: CCN 883964

Legal name

CHRISTOPHER D MARSHALL MD PLLC

Doing business as

MEDICAL SPECIALTY CLINIC

Certification status

Active

Provider type (POS)

Rural health clinic

Participating since

Apr 22, 2024

Last certification

Apr 22, 2024

Ownership / control type

1A

Organization structure

LLCProprietary

Enrollment address

190 University Ave
Parsons, TN 38363-2972

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

All disclosed owners & managing parties 2

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

• Christopher Dean Averett Marshall, MD

  • Family Medicine Physician
  • Parsons, TN
  • NPI 1144425075

  5% Or Greater Direct Ownership Interest, Corporate Officer, Operational/Managerial Control

  CMS ownership

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Christopher Dean Averett Marshall, MD

  • Family Medicine Physician
  • Parsons, TN
  • NPI 1144425075
  Medicare reassignment Care Compare group NPD Authorized official
• Brooke Bedwell

  • Family Nurse Practitioner
  • Parsons, TN
  • NPI 1467104570
  Medicare reassignment Care Compare group NPD
• Charleston Bailee Wallace, FNP

  • Family Nurse Practitioner
  • Lexington, TN
  • NPI 1851960421
  Medicare reassignment Care Compare group NPD
• Tiffani White

  • Family Nurse Practitioner
  • Parsons, TN
  • NPI 1821469065
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1424131200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1729036800000",
    "number": "1659762391",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "190 UNIVERSITY AVE",
            "city": "PARSONS",
            "state": "TN",
            "postal_code": "383632972",
            "telephone_number": "731-257-1500",
            "fax_number": "731-257-1501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "190 UNIVERSITY AVE",
            "city": "PARSONS",
            "state": "TN",
            "postal_code": "383632972",
            "telephone_number": "731-845-3813",
            "fax_number": "731-257-1501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHRISTOPHER D MARSHALL MD PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-02-17",
        "last_updated": "2024-10-16",
        "certification_date": "2024-10-16",
        "status": "A",
        "authorized_official_last_name": "MARSHALL",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_middle_name": "DEAN AVERETT",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "731-257-1500",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "KY",
            "license": "41991",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TN",
            "license": "42847",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "KY",
            "license": "41991",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TN",
            "license": "42847",
            "primary": false
        },
        {
            "code": "207QA0401X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Addiction Medicine",
            "state": "KY",
            "license": "41991",
            "primary": false
        },
        {
            "code": "207QA0401X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Addiction Medicine",
            "state": "TN",
            "license": "42847",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CHRISTOPHER D MARSHALL MD PLLC",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "CHRISTOPHER D MARSHALL MD PLLC",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Medical Specialty Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Cynthia Hinson Carroll, NP-C
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• Mary Cruse, M.A.,CCC-SLP

• Rural Health Clinic/Center in Parsons, TN
• Providers in Parsons, TN by specialty
• Rural Health Clinic/Center in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• 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.