NPIMap

Individual provider Active NPI

Lilly Rose Marshall, M.D.

  • Family Medicine Physician
  • Pensacola, FL
National Provider Identifier
1942247325
Registry record updated Jun 13, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
ME62784 Issued in FL
Practice address
2200 N Palafox St
Pensacola, FL 32501-1723
Phone
(850) 436-4630
Fax
(850) 436-2095
NPI assigned
Jun 2, 2006
Last updated
Jun 13, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 13, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X G52007 CA
Family Medicine Physician 207Q00000X ME62784 FL Primary

Addresses

Primary practice location

2200 N Palafox St
Pensacola, FL 32501-1723

Mailing address

2200 N Palafox St
Pensacola, FL 32501-1723
Phone (850) 436-4630

Other identifiers 3

IdentifierTypeStateIssuer
001171600MedicaidFL
18963VOtherFLMEDICARE PTAN
00G520070MedicaidCA

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

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Medicine Specialists PLC Emergency Medicine Past Accepting new patients
Santa Rosa Hma Physician Management LLC Family Medicine PastSince Jul 4, 2021 Accepting new patients
West Florida Regional Medical Center Past Accepting new patients
Lilly Rose Marshall Medical Corp. PastSince Dec 26, 2006 Accepting new patients
Santa Rosa Hma Urgent Care LLC Past Accepting new patients
Santa Rosa Hma Physician Management, LLC Family Medicine PastSince May 1, 2012 Accepting new patients
Sherman Oaks Emergency Medical Associates Emergency Medicine PastSince Nov 15, 2020 Accepting new patients

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1149206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1371081600000",
    "number": "1942247325",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2200 N PALAFOX ST",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325011723",
            "telephone_number": "850-436-4630",
            "fax_number": "850-436-2095"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2200 N PALAFOX ST",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325011723",
            "telephone_number": "850-436-4630",
            "fax_number": "850-436-2095"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARSHALL",
        "first_name": "LILLY",
        "middle_name": "ROSE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-02",
        "last_updated": "2013-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "G52007",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME62784",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001171600",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "18963V",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G520070",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pensacola, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2013; 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.