Jackson Marshall, AUD

Primary specialty

AudiologistTaxonomy code 231H00000X

License

2104 Issued in TN

Practice address

1410 Tusculum Blvd Ste 2500
Greeneville, TN 37745-5821

Phone

(423) 638-1291

Fax

(423) 638-9398

NPI assigned

Jul 21, 2023

Last updated

Jul 21, 2023By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TN

Enrollment records 1

Specialty

Qualified Audiologist

Education

University of Tennessee, HSC, College of Medicine, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Greeneville Ear, Nose and Throat Specialists, MpllcGroup PAC ID 4385607126, 4 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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

• Greeneville Ear, Nose & Throat Specialists, Mpllc

  • Specialist
  • Greeneville, TN
  • NPI 1700965878
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1689897600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689897600000",
    "number": "1881374114",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1410 TUSCULUM BLVD STE 2500",
            "city": "GREENEVILLE",
            "state": "TN",
            "postal_code": "377455821",
            "telephone_number": "423-638-1291",
            "fax_number": "423-638-9398"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1410 TUSCULUM BLVD STE 2500",
            "city": "GREENEVILLE",
            "state": "TN",
            "postal_code": "377455821",
            "telephone_number": "423-638-1291",
            "fax_number": "423-638-9398"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARSHALL",
        "first_name": "JACKSON",
        "credential": "AUD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-07-21",
        "last_updated": "2023-07-21",
        "certification_date": "2023-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "TN",
            "license": "2104",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mason Manship, PHARMD
• Melissa Lee Marcou, BS
• Philip A Marino Jr., MD
• Gordon Marsa, M.D.
• Marshall Lane
• Miriah Elizabeth Martin
• Aurora T. Marty, MD
• Walter Lawrence Mason, M.D.
• Mina A Massey, LCSW
• Kristi Michelle Mathis, PTA

• Audiologist in Greeneville, TN
• Providers in Greeneville, TN by specialty
• Audiologist in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.