Active NPI
John B Marshall, MD
- Gastroenterology Physician
- Columbia, MO
National Provider Identifier
1689623753
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Gastroenterology Physician
- License
- MDR2A21
- Practice address
- One Hospital Dr
Columbia, MO 65212-0001 - Phone
- (573) 882-8788
- Fax
- (573) 882-3131
- NPI assigned
- May 8, 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 |
|---|---|---|---|---|
| Gastroenterology Physician | 207RG0100X | MDR2A21 | MO | Primary |
Addresses
Primary practice location
One Hospital Dr
Columbia, MO 65212-0001
Mailing address
PO Box 7687
Columbia, MO 65205-7687
Phone (573) 882-2259
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 202451407 | Medicaid | MO |
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MDR2A21 | MO | MD | Gastroenterology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147046400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1344556800000",
"number": "1689623753",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 7687",
"city": "COLUMBIA",
"state": "MO",
"postal_code": "652057687",
"telephone_number": "573-882-2259"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "ONE HOSPITAL DR",
"city": "COLUMBIA",
"state": "MO",
"postal_code": "652120001",
"telephone_number": "573-882-8788",
"fax_number": "573-882-3131"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARSHALL",
"first_name": "JOHN",
"middle_name": "B",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-05-08",
"last_updated": "2012-08-10",
"status": "A"
},
"taxonomies": [
{
"code": "207RG0100X",
"taxonomy_group": "",
"desc": "Internal Medicine, Gastroenterology",
"state": "MO",
"license": "MDR2A21",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "202451407",
"state": "MO"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Columbia, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.