Individual provider Active NPI

James Warner Marshall Jr., D.O.

  • Internal Medicine Physician
  • Orange, CT
National Provider Identifier
1871597310
Registry record updated Jul 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
000204 Issued in CT
Practice address
521 Boston Post Rd
Orange, CT 06477-3506
Phone
(203) 529-3271
Fax
(203) 529-3273
NPI assigned
Jun 13, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 000204 CT Primary

Addresses

Primary practice location

521 Boston Post Rd
Orange, CT 06477-3506

Mailing address

64 Russell Ave
Orange, CT 06477-2505
Phone (203) 913-2538

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
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
I20100901000844 CT Practitioner - Internal Medicine 0941324610 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Univ of New England, College of Dental Medicine, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Docs Medical IncGroup PAC ID 3173895000, 30 clinicians
CT Medical Group Inc.Group PAC ID 9739663105, 35 clinicians

Practice addresses (Care Compare)

521 Boston Post Rd
Orange, CT 06477-3506
Phone (203) 874-3682

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
000204CTMDNaturopath
204CTMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Docs Medical Inc Internal Medicine CurrentSince Jun 5, 2023 Accepting new patients
Ophthalmic Consultants of Connecticut PC Past Accepting new patients

Locations

317 Foxon Rd
East Haven, CT 06513
Phone (203) 484-9333

317 Foxon Rd
Ste 2
East Haven, CT 06513

521 Boston Post Rd
Orange, CT 06477
Phone (203) 529-3271

Organizations & group practices 3

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": "1118620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625875200000",
    "number": "1871597310",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "64 RUSSELL AVE",
            "city": "ORANGE",
            "state": "CT",
            "postal_code": "064772505",
            "telephone_number": "203-913-2538"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "521 BOSTON POST RD",
            "city": "ORANGE",
            "state": "CT",
            "postal_code": "064773506",
            "telephone_number": "203-529-3271",
            "fax_number": "203-529-3273"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARSHALL",
        "first_name": "JAMES",
        "middle_name": "WARNER",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-13",
        "last_updated": "2021-07-10",
        "certification_date": "2021-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CT",
            "license": "000204",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orange, CT

Sources for this page

Verify at the official NPI Registry.