Active NPI
C Perry Marshall, MD
- Occupational Medicine Physician
- Tyler, TX
National Provider Identifier
1801996988
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Medicine Physician
- License
- N1757
- Practice address
- 1327 Troup Hwy
Tyler, TX 75701-4443 - Phone
- (903) 581-4300
- NPI assigned
- Sep 25, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Physician | 208D00000X | MD-8243 | HI | |
| General Practice Physician | 208D00000X | 020238 | GA | |
| Occupational Medicine Physician | 2083X0100X | MD 8243 | HI | |
| Occupational Medicine Physician | 2083X0100X | N1757 | TX | Primary |
Addresses
Primary practice location
1327 Troup Hwy
Tyler, TX 75701-4443
Mailing address
PO Box 841656
Dallas, TX 75284-1656
Phone (903) 531-5000
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 047915-03 | Medicaid | HI | |
| 0000054536 | Other | HI | HMSA BILLING NUMBER |
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
| License | State | Type | Specialty |
|---|---|---|---|
| MD 8243 | HI | MD | Occupational Medicine Physician |
| N1757 | TX | MD | Occupational Medicine Physician |
| 020238 | GA | MD | General Practice Physician |
| MD-8243 | HI | MD | General Practice Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159142400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1399852800000",
"number": "1801996988",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 841656",
"city": "DALLAS",
"state": "TX",
"postal_code": "752841656",
"telephone_number": "903-531-5000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1327 TROUP HWY",
"city": "TYLER",
"state": "TX",
"postal_code": "757014443",
"telephone_number": "903-581-4300"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARSHALL",
"first_name": "C PERRY",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-09-25",
"last_updated": "2014-05-12",
"status": "A"
},
"taxonomies": [
{
"code": "208D00000X",
"taxonomy_group": "",
"desc": "General Practice",
"state": "HI",
"license": "MD-8243",
"primary": false
},
{
"code": "208D00000X",
"taxonomy_group": "",
"desc": "General Practice",
"state": "GA",
"license": "020238",
"primary": false
},
{
"code": "2083X0100X",
"taxonomy_group": "",
"desc": "Preventive Medicine, Occupational Medicine",
"state": "HI",
"license": "MD 8243",
"primary": false
},
{
"code": "2083X0100X",
"taxonomy_group": "",
"desc": "Preventive Medicine, Occupational Medicine",
"state": "TX",
"license": "N1757",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "047915-03",
"state": "HI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HMSA BILLING NUMBER",
"identifier": "0000054536",
"state": "HI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Tyler, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.