Organization Active NPI

Christopher D Marshall MD PLLC

Doing business as Medical Specialty Clinic

  • Rural Health Clinic/Center
  • Parsons, TN
National Provider Identifier
1659762391
Registry record updated Oct 16, 2024
On this page

Key facts

NPPES NPI Registry
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

NPPES NPI Registry

Updated by the provider on Oct 16, 2024

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

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 8

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X Primary
Emergency Medicine Physician 207P00000X 41991 KY
Emergency Medicine Physician 207P00000X 42847 TN
Family Medicine Physician 207Q00000X 41991 KY
Family Medicine Physician 207Q00000X
Family Medicine Physician 207Q00000X 42847 TN
Addiction Medicine (Family Medicine) Physician 207QA0401X 41991 KY
Addiction Medicine (Family Medicine) Physician 207QA0401X 42847 TN

Addresses

Primary practice location

190 University Ave
Parsons, TN 38363-2972

Mailing address

190 University Ave
Parsons, TN 38363-2972
Phone (731) 257-1500

Other names 2

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

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20150227001178 TN Part B Supplier - Clinic/Group Practice 5496071904 Receives reassigned benefits from 4 practitioners
Practice locations: Parsons, TN
O20230825000641 TN Part A Provider - Rural Health Clinic 5496071904 Practice locations: Parsons, TN

NPI to CCN mapping 1

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

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

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
44D2223391Medical Specialty Clinic190 University Ave, Parsons, TN 38363Provider-performed microscopyMay 5, 2027

National Provider Directory

National Provider Directory

Locations

1869 Highway 45 Byp
#5
Jackson, TN 38305
Phone (731) 660-0880

190 University Ave
Parsons, TN 38363
Phone (731) 257-1500

2220 Highway 641 S
Parsons, TN 38363
Phone (731) 733-3311

526 Florida Ave N
Parsons, TN 38363
Phone (731) 201-1314

Ownership & related parties

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.

NameRoleSinceShare
Christopher D Marshall Individual 5% Or Greater Direct Ownership Interest Jan 21, 2015 100%
Corporate OfficerPres Jan 21, 2015 100%
Operational/Managerial ControlPres Jan 21, 2015 100%
Lori Tubbs Individual W-2 Managing EmployeeLicensed Practical Nurse Oct 1, 2021

Owners & managing parties with NPI records 1

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

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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"
        }
    ]
}

Other providers in Parsons, TN

Sources for this page

Verify at the official NPI Registry.