NPIMap

Individual provider Active NPI

Gena Willard Marshall, PA-C

  • Physician Assistant
  • Dallas, TX
National Provider Identifier
1922095173
Registry record updated Aug 28, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA03192 Issued in TX
Practice address
9101 N Central Expy Ste 600
Dallas, TX 75231-5956
Phone
(214) 818-0935
NPI assigned
Oct 3, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2017

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA03192 TX
Surgical Physician Assistant 363AS0400X PA03192 TX
Physician Assistant 363A00000X PA03192 TX Primary

Addresses

Primary practice location

9101 N Central Expy Ste 600
Dallas, TX 75231-5956

Mailing address

9101 North Central Expressway
Suite 600
Dallas, TX 75231

Other identifiers 11

IdentifierTypeStateIssuer
206246501MedicaidTX
8376NDOtherTXBLUE CROSS BLUE SHIELD
1922095173OtherTXBLUE CROSS BLUE SHIELD
P01107875OtherTXRR MEDICARE
206246502MedicaidTX
8Y8690OtherTXBLUE CROSS BLUE SHIELD
P00735961OtherTXRAILROAD MEDICARE
206246504MedicaidTX
P01259383OtherTXMEDICARE RR
864N28OtherTXBCBS
206246503MedicaidTX

Other names 1

  • Gena Willard Former name

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
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA03192TXMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
United Regional Health Care System Inc Current Accepting new patients
Texas Endosurgery Associates PastSince Aug 1, 2006 Accepting new patients
Texas Surgical Arts Past Accepting new patients
QSS-Southeast Clinical Services LLC Past Accepting new patients
Partners in Practice, Inc. Physician Assistant Past Accepting new patients
Qualified Surgical Services PLLC Past Accepting new patients
Ut Physicians Physician Assistant Past Accepting new patients
TMH Physician Associates PLLC Past Accepting new patients
Ut Physicians Past Accepting new patients
Martin & Willard, LLC Physician Assistant PastSince May 1, 2008 Accepting new patients

Interoperability endpoints

  • FHIR API: https://epicproxy.et1096.epichosted.com/FHIRProxy/api/fhir/r4/
  • Direct secure messaging: gmarshall14213@unitedregional.medalliesdirect.net
  • FHIR API: https://epicproxy.et1096.epichosted.com/FHIRProxy/api/FHIR/DSTU2/

Organizations & group practices 10

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": "1128297600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1503878400000",
    "number": "1922095173",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9101 NORTH CENTRAL EXPRESSWAY",
            "address_2": "SUITE 600",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "75231"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9101 N CENTRAL EXPY STE 600",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752315956",
            "telephone_number": "214-818-0935"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARSHALL",
        "first_name": "GENA",
        "middle_name": "WILLARD",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-03",
        "last_updated": "2017-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "TX",
            "license": "PA03192",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "TX",
            "license": "PA03192",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA03192",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "206246501",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "8376ND",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "1922095173",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P01107875",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "206246502",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "8Y8690",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00735961",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "206246504",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RR",
            "identifier": "P01259383",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "864N28",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "206246503",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "GENA",
            "last_name": "WILLARD",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Dallas, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.