Eric John Marshall, DC – Chiropractor in St Clair, MI

Key facts

NPI: 1952394637
Entity type: Individual (NPI type 1)
Primary specialty: Chiropractor 111N00000X
License: 2301007100 (MI)
Practice address: 1605 Fred Moore Hwy
St Clair, MI 48079-5296
Phone: (810) 329-6100
Fax: (810) 329-8650
NPI assigned: Aug 26, 2005
Sex: Male
Sole proprietor: No

Organizations & group practices 1

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.

Marshall Family Chiropractic, PC Chiropractor · Saint Clair, MI · NPI 1134145691

Medicare reassignment Care Compare group NPD Authorized official CHIROPRACTOR · MI

Medicare Care Compare profile

Specialty: Chiropractic
Education: National College of Chiropractic, 1994
Medicare assignment: Accepts the Medicare-approved amount as payment in full
Group practices: Marshall Family Chiropractic PC (2 clinicians)

Practice addresses (Care Compare)

1605 Fred Moore Hwy
Saint Clair, MI 48079-5296

Medicare participation

Medicare fee-for-service enrollment: Enrolled in MI

Medicare enrollment records

Enrollment ID	State	Provider type	PAC ID	Details
I20060908000158	MI	Practitioner - Chiropractic	1052315884	Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD): Yes

State licenses

License	State	Type	Specialty
2301007100	MI	MD	Chiropractor

Practice roles

Organization	Specialty	Status	New patients
Marshall Family Chiropractic, PC	Chiropractor	Current since Sep 6, 2006	Accepting new patients

Locations

1605 Fred W Moore Hwy
Saint Clair, MI 48079
Phone (810) 329-6100

Interoperability endpoints

Direct secure messaging: dreric@mfc0017.direct.chirotouch.md

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Chiropractor	111N00000X	2301007100	MI	Yes

Addresses

Primary practice location

1605 Fred Moore Hwy
St Clair, MI 48079-5296

Mailing address

1605 Fred Moore Hwy
St Clair, MI 48079-5296
Phone (810) 329-6100

Other identifiers

Identifier	Type	State	Issuer
3326787	Medicaid	MI

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Sep 17, 2012.

{
    "created_epoch": "1125014400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1347840000000",
    "number": "1952394637",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1605 FRED MOORE HWY",
            "city": "ST CLAIR",
            "state": "MI",
            "postal_code": "480795296",
            "telephone_number": "810-329-6100",
            "fax_number": "810-329-8650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1605 FRED MOORE HWY",
            "city": "ST CLAIR",
            "state": "MI",
            "postal_code": "480795296",
            "telephone_number": "810-329-6100",
            "fax_number": "810-329-8650"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARSHALL",
        "first_name": "ERIC",
        "middle_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-26",
        "last_updated": "2012-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MI",
            "license": "2301007100",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3326787",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in St Clair, MI

All providers in St Clair, MI · Chiropractor in Michigan

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 17, 2012. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
Medicare Care Compare provider data (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.