Tarena Marshall, LAT, ATC

Primary specialty

Sports Medicine (Family Medicine) PhysicianTaxonomy code 207QS0010X

License

320938 Issued in LA

Practice address

403 Main St
Grambling, LA 71245-2715

Phone

(601) 382-5170

NPI assigned

Jun 5, 2023

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1685923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1685923200000",
    "number": "1730873753",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 FAITH LN",
            "city": "MENDENHALL",
            "state": "MS",
            "postal_code": "391145831",
            "telephone_number": "601-382-5170"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "403 MAIN ST",
            "city": "GRAMBLING",
            "state": "LA",
            "postal_code": "712452715",
            "telephone_number": "601-382-5170"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARSHALL",
        "first_name": "TARENA",
        "credential": "LAT, ATC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-06-05",
        "last_updated": "2023-06-05",
        "certification_date": "2023-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "LA",
            "license": "320938",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Warren Johnson Jr., MHS
• Otis Jones
• Taylor Knighten
• Kourtney Lee
• Patrice Michelle Lewis-Outley, F.N.P
• Demarcus Joe McKinney
• Schwanna Mitchell, MS
• Carla Harvey Moore, LMSW
• Jye Shuang NG
• Danna Page Pray, MA, LPC

• Sports Medicine (Family Medicine) Physician in Grambling, LA
• Providers in Grambling, LA by specialty
• Sports Medicine (Family Medicine) Physician in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.