Individual provider Active NPI

Cullen Spencer Marshall, M.D.

  • Neurology with Special Qualifications in Child Neurology Physician
  • Louisville, KY
National Provider Identifier
1770016602
Registry record updated Mar 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology with Special Qualifications in Child Neurology PhysicianTaxonomy code 2084N0402X
License
TP739 Issued in KY
Practice address
411 E Chestnut St # 6
Louisville, KY 40202-1713
Phone
(502) 588-3650
Fax
(502) 588-7852
NPI assigned
Apr 7, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 26, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Neurology with Special Qualifications in Child Neurology Physician 2084N0402X TP739 KY Primary

Addresses

Primary practice location

411 E Chestnut St # 6
Louisville, KY 40202-1713

Mailing address

PO Box 776879
Chicago, IL 60677-6879
Phone (502) 588-9490

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220721003135 KY Practitioner - Neurology 9739560707 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
TP739KYMDNeurology with Special Qualifications in Child Neurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Norton Children'S Medical Group, LLC Neurology With Special Qualifications in Child Neurology CurrentSince Aug 1, 2022 Accepting new patients
Norton Children'S Medical Group, LLC CurrentSince Aug 1, 2022 Accepting new patients
Norton Children'S Medical Group, LLC Current Accepting new patients
Norton Childrens Medical Group, LLC Past Accepting new patients
Commission for Children With Special Health Car Past Accepting new patients

Locations

125 Kingswood Dr
Campbellsville, KY 42718
Phone (270) 789-1112

57 Summit Dr
Corbin, KY 40701
Phone (606) 528-9700

1301 N Race St
Glasgow, KY 42141
Phone (270) 651-4141

4123 Dutchmans Ln
Ste 102
Louisville, KY 40207
Phone (502) 559-1670

411 E Chestnut St
#6
Louisville, KY 40202
Phone (502) 588-9587

601 S Floyd St
Ste 604
Louisville, KY 40202
Phone (502) 559-1670

310 Whittington Pkwy
Ste 200
Louisville, KY 40222
Phone (502) 429-1249

530 S Jackson St
Louisville, KY 40202
Phone (502) 562-3000

4910 Chamberlain Ln
Louisville, KY 40241
Phone (502) 446-5000

803 Poplar St
Murray, KY 42071
Phone (270) 762-1155

1000 Breckenridge St
Ste 301
Owensboro, KY 42303
Phone (270) 852-8894

1707 Cedar Grove Rd
Ste 15
Shepherdsville, KY 40165
Phone (502) 543-3246

Interoperability endpoints

  • Direct secure messaging: cmarshall85254@direct.nortonhealthcare.org

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1491523200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711411200000",
    "number": "1770016602",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 776879",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606776879",
            "telephone_number": "502-588-9490",
            "fax_number": "502-272-5339"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "411 E CHESTNUT ST # 6",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402021713",
            "telephone_number": "502-588-3650",
            "fax_number": "502-588-7852"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARSHALL",
        "first_name": "CULLEN",
        "middle_name": "SPENCER",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-04-07",
        "last_updated": "2024-03-26",
        "certification_date": "2024-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084N0402X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology",
            "state": "KY",
            "license": "TP739",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

Verify at the official NPI Registry.