Organization Active NPI

Marshall Pediatrics Inc

  • Pediatrics Physician
  • Sidney, OH
National Provider Identifier
1730645458
Registry record updated Feb 19, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
MARSHALL PEDIATRICS INC
Practice address
322 2ND Ave
Sidney, OH 45365-1263
Phone
(937) 217-9393
NPI assigned
Feb 19, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 19, 2019

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

Authorized official

Name
Sarah Marshall, MDNPI 1619959723
Title
Owner
Phone
(937) 217-9393

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208000000X Primary

Addresses

Primary practice location

322 2ND Ave
Sidney, OH 45365-1263

Mailing address

204 Peridot Dr
Anna, OH 45302-8632
Phone (937) 217-9393

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190508002035 OH Part B Supplier - Clinic/Group Practice 1153663398 Receives reassigned benefits from 1 practitioner
Practice locations: Sidney, OH

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
36D2162846Marshall Pediatrics322 2ND Ave, Sidney, OH 45365Certificate of waiverFeb 28, 2027

National Provider Directory

National Provider Directory

Locations

322 2nd Ave
Sidney, OH 45365
Phone (937) 492-9128

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/21496/brand/1/csg/1/fhir/r4

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1550534400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1550534400000",
    "number": "1730645458",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "204 PERIDOT DR",
            "city": "ANNA",
            "state": "OH",
            "postal_code": "453028632",
            "telephone_number": "937-217-9393"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "322 2ND AVE",
            "city": "SIDNEY",
            "state": "OH",
            "postal_code": "453651263",
            "telephone_number": "937-217-9393"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARSHALL PEDIATRICS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-02-19",
        "last_updated": "2019-02-19",
        "status": "A",
        "authorized_official_last_name": "MARSHALL",
        "authorized_official_first_name": "SARAH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "937-217-9393",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sidney, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.