Individual provider Active NPI

Michael Marsh, MD

  • Family Medicine Physician
  • Dayton, VA
National Provider Identifier
1760458277
Registry record updated Aug 12, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
0101-35025 Issued in VA
Practice address
15 Killdeer LN
Dayton, VA 22821-9745
Phone
(540) 879-2585
NPI assigned
Feb 24, 2006
Last updated
Aug 12, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 0101-35025 VA Primary

Addresses

Primary practice location

15 Killdeer LN
Dayton, VA 22821-9745

Mailing address

9170 Doe Hill Rd
Port Republic, VA 24471-2119

Other identifiers 1

IdentifierTypeStateIssuer
005622999MedicaidVA

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

LicenseStateTypeSpecialty
0101-35025VAMDFamily Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1140739200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1313107200000",
    "number": "1760458277",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9170 DOE HILL RD",
            "city": "PORT REPUBLIC",
            "state": "VA",
            "postal_code": "244712119"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 KILLDEER LN",
            "city": "DAYTON",
            "state": "VA",
            "postal_code": "228219745",
            "telephone_number": "540-879-2585"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARSH",
        "first_name": "MICHAEL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-24",
        "last_updated": "2011-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "VA",
            "license": "0101-35025",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "005622999",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dayton, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2011; 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.