Kenneth Douglas Marshall, MD

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

01023941 Issued in IN

Practice address

915 N Capitol Ave
Indianapolis, IN 46204-1004

Phone

(317) 631-0420

Fax

(317) 631-0454

NPI assigned

Feb 2, 2007

Sex

Male

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Meridian Medical Services, Inc

  dba Meridian Radiology

  • General Practice Physician
  • Indianapolis, IN
  • NPI 1255579942
  NPD (past)

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

{
    "created_epoch": "1170374400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1922146885",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "915 N CAPITOL AVE",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462041004",
            "telephone_number": "317-631-0420",
            "fax_number": "317-631-0454"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "915 N CAPITOL AVE",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462041004",
            "telephone_number": "317-631-0420",
            "fax_number": "317-631-0454"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARSHALL",
        "first_name": "KENNETH",
        "middle_name": "DOUGLAS",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-02",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "IN",
            "license": "01023941",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anthony Marshall
• Brooke Marie Marshall, PSY.D
• Debra Ann Marshall, LCSW
• Joycelynn Marshall
• Katherine Elaine Marshall, CNM
• Latoya Marie Marshall
• Luan Marshall
• Max L Marshall, RPH
• Melissa K Marshall, MSW, LCSW, LCAC
• Nancy E Marshall, MD

• General Practice Physician in Indianapolis, IN
• Providers in Indianapolis, IN by specialty
• General Practice Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.