V Blake Marshall Jr., DO

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

OS005994 Issued in PA

Practice address

2230 Cottman Ave
Phila, PA 19149-1230

Phone

(215) 685-0603

Fax

(215) 725-4877

NPI assigned

Jun 7, 2006

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

Other identifiers 1

Other names 1

• Dr. Virgil Blake Marshall Jr. Other name

Medicare fee-for-service enrollment

Enrolled in PA

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

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 and National Provider Directory roles.

• City of Philadelphia

  • Federally Qualified Health Center (FQHC)
  • Philadelphia, PA
  • NPI 1942317094
  Medicare reassignment NPD
• City of Philadelphia

  • Federally Qualified Health Center (FQHC)
  • Philadelphia, PA
  • NPI 1427165307
  NPD
• City of Philadelphia

  • Clinical Medical Laboratory
  • Phila, PA
  • NPI 1689688798
  NPD

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

{
    "created_epoch": "1149638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1952341992",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2410 DELANCEY ST",
            "city": "PHILA",
            "state": "PA",
            "postal_code": "191036409",
            "telephone_number": "215-732-7178",
            "fax_number": "215-725-4877"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2230 COTTMAN AVE",
            "city": "PHILA",
            "state": "PA",
            "postal_code": "191491230",
            "telephone_number": "215-685-0603",
            "fax_number": "215-725-4877"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARSHALL",
        "first_name": "V",
        "middle_name": "BLAKE",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-07",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "OS005994",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001133997",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "VIRGIL",
            "last_name": "MARSHALL",
            "middle_name": "BLAKE",
            "prefix": "DR.",
            "suffix": "JR.",
            "credential": "DO",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Harold H Marcus, DDS
• Joni R Marcus, DMD
• Carol N Marder, CRNP
• Mark Allen Orthopedic Clinic
• Litefia Arnita Marrow
• Delinda Jane Martell, O.D.
• Brunette Marthone, B.S.
• Cherrelle D Martin, BS
• Vanessa Martin, LPC
• Sandra Masayko

• Internal Medicine Physician in Phila, PA
• Providers in Phila, PA by specialty
• Internal Medicine Physician in Pennsylvania

• 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.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.