Individual provider Active NPI

Eric Marshall, PA

  • Physician Assistant
  • Jackson, MI
National Provider Identifier
1770030611
Registry record updated Sep 8, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
5601007843 Issued in MI
Practice address
1100 E Michigan Ave Ste 201
Jackson, MI 49201-1849
Phone
(517) 205-7069
Fax
(517) 205-7047
NPI assigned
Sep 8, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 8, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 5601007843 MI Primary

Addresses

Primary practice location

1100 E Michigan Ave Ste 201
Jackson, MI 49201-1849

Mailing address

1100 E Michigan Ave Ste 201
Jackson, MI 49201-1849
Phone (517) 205-7069

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160915002217 MI Practitioner - Physician Assistant 3678869732 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

205 N E Ave
Jackson, MI 49201-1753

7845 Spring Arbor Rd
Spring Arbor, MI 49283-9785
Phone (517) 205-2580

813 W Michigan Ave
Henry Ford Allegiance Osteoporosis Center
Jackson, MI 49202-4158
Phone (517) 205-1000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
5601007843MIMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
W.a. Foote Memorial Hospital, Inc Physician Assistant CurrentSince Oct 3, 2017 Accepting new patients
W.a. Foote Memorial Hospital, Inc CurrentSince Oct 3, 2017 Accepting new patients
Wa Foote Memorial Hospital, Inc Physician Assistant Past Accepting new patients

Locations

1100 E Michigan Ave
Ste 209
Jackson, MI 49201
Phone (517) 205-8346

1100 E Michigan Ave
Ste 201
Jackson, MI 49201
Phone (517) 205-7605

813 W Michigan Ave
Jackson, MI 49202
Phone (517) 205-1000

205 N East Ave
Jackson, MI 49201
Phone (517) 788-4730

7845 Spring Arbor Rd
Spring Arbor, MI 49283
Phone (517) 205-2580

Organizations & group practices 4

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1473292800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1473292800000",
    "number": "1770030611",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 E MICHIGAN AVE STE 201",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492011849",
            "telephone_number": "517-205-7069",
            "fax_number": "517-205-7047"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 E MICHIGAN AVE STE 201",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492011849",
            "telephone_number": "517-205-7069",
            "fax_number": "517-205-7047"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARSHALL",
        "first_name": "ERIC",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-09-08",
        "last_updated": "2016-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601007843",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, MI

Sources for this page

Verify at the official NPI Registry.