NPIMap

Organization Active NPI

Marshall Medical Center

  • General Acute Care Hospital
  • Placerville, CA
National Provider Identifier
1972503142
Registry record updated Sep 25, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Acute Care HospitalTaxonomy code 282N00000X
License
030000059 Issued in CA
Legal business name
MARSHALL MEDICAL CENTER
Practice address
1100 Marshall Way
Placerville, CA 95667-6533
Phone
(530) 626-2601
Fax
(530) 622-7853
NPI assigned
Jul 28, 2005
Last updated
Sep 25, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2026

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

Authorized official

Name
Martin Entwistle
Title
Interim Ceo
Phone
(530) 626-2868

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Acute Care Hospital 282N00000X 030000059 CA Primary

Addresses

Primary practice location

1100 Marshall Way
Placerville, CA 95667-6533

Mailing address

1100 Marshall Way
Placerville, CA 95667-6533
Phone (530) 626-2763

Other identifiers 2

IdentifierTypeStateIssuer
ZZR00254FMedicaidCA
HSP40254FMedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20071214000243 CA Part A Provider - Hospital 7517875859 Practice locations: Placerville, CA; El Dorado Hills, CA; Cameron Park, CA
O20220428001467 CA Part B Supplier - Intensive Cardiac Rehabilitation 7517875859 Receives reassigned benefits from 1 practitioner
Practice locations: Placerville, CA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1972503142. Details of each certification follow.

Hospital certification: CCN 050254

Legal name
MARSHALL MEDICAL CENTER
Doing business as
MARSHALL HOSPITAL
Certification status
Active
Provider type (POS)
Hospital – Short-term
Participating since
Jul 1, 1966
Last certification
Jan 31, 2020
Beds
111
Ownership / control type
Private (not for profit)
Organization structure
CorporationNon-profit
Incorporated
Mar 21, 1957 in CA
Enrollment address
1100 Marshall Way
Placerville, CA 95667-6533
Main/Primary Hospital Location
Hospital subgroups
Acute care

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs with the same Medicare PAC ID 6

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Care Compare: Hospital

Medicare Care Compare
Listed as
Marshall Medical CenterCCN 050254 · All quality measures
Overall star rating
4 of 5
Type
Acute Care Hospitals
Ownership
Voluntary non-profit - Private
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D0909775Marshall Hospital Poct Laboratory1100 Marshall Way, Placerville, CA 95667Certificate of waiverDec 16, 2027

National Provider Directory

National Provider Directory
Tax ID family
Marshall Hosp Pul Funct18 organizations share this tax ID, including this one

Other organizations with this tax ID 17

Organizations that report the same tax identification number in the National Provider Directory.

View all 17

Locations

3102 Ponte Morino Dr
Ste 100
Cameron Park, CA 95682
Phone (530) 626-9488

5137 Golden Foothill Pkwy
Ste 120
El Dorado Hls, CA 95762
Phone (530) 344-5400

1050 Marshall Way
Placerville, CA 95667

Networks

  • BSC 65 PLUS INDIVIDUAL MAPDPlans: Blue Shield 65 Plus (HMO) (H0504-015-000, H0504); Blue Shield 65 Plus (HMO) (H0504-039-000, H0504); Blue Shield 65 Plus Plan 2 (HMO) (H0504-021-000, H0504); Blue Shield Inspire (HMO) (H0504-041-000, H0504); Blue Shield 65 Plus (HMO) (H0504-038-000, H0504); Blue Shield Inspire (HMO) (H0504-047-000, H0504); Blue Shield 65 Plus (HMO) (H0504-026-000, H0504); Blue Shield Advantage (HMO) (H0504-050-000, H0504); Blue Shield AdvantageOptimum Plan (HMO) (H5928-004-000, H5928); Blue Shield Inspire (HMO) (H0504-043-000, H0504)…

Ownership & related parties

All disclosed owners & managing parties 16

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Sylvia Doane-Stephenson Individual Corporate DirectorBoard of Director Jun 27, 2024 6.66%
Leanne M Camisa Individual Corporate DirectorChief of Staff Jan 1, 2025 6.66%
Brian Keith Veerkamp Individual Corporate DirectorBoard of Director Mar 31, 2020 6.66%
Jon Christian Haugaard Individual Corporate DirectorBoard Chair Mar 31, 2018 6.66%
John Rodman Knight Individual Corporate DirectorTreasurer/Secretary Mar 31, 2020 6.66%
Siri Nelson Individual Corporate OfficerCeo Jan 1, 2020 25%
W-2 Managing EmployeeCeo Jan 1, 2020
Kim Stoll Individual Corporate DirectorBoard of Directors Mar 31, 2023 6.66%
Anna-Nicole M Blair Individual Corporate DirectorBoard of Directors Mar 31, 2023 6.66%
Jonathan Russell Individual Corporate OfficerChief Ambulatory Officer Dec 27, 2020 25%
W-2 Managing EmployeeCao Feb 5, 2007
Office of Statewide Health Planning and Development Organization, Sacramento, CA 5% Or Greater Mortgage Interest Oct 1, 1986 29.55%
5% Or Greater Security Interest Oct 1, 1986 29.55%
Michael Lewis Purvis Individual Corporate DirectorBoard of Directors Jan 25, 2024 6.66%
Gerardo S Galang Individual Corporate DirectorBoard of Directors Jul 1, 2022 6.66%
Thomas Cumpston Individual Corporate DirectorVice Chair Mar 31, 2019 6.66%
US Bank National Association Organization, Monterey Park, CA Financial institution 5% Or Greater Mortgage Interest May 30, 2023 29.55%
5% Or Greater Security Interest May 30, 2023 29.55%
Alexis F Long Individual Corporate DirectorBoard of Director Mar 25, 2021 6.66%
Cynthia Anne Rice Individual Corporate OfficerChief Nursing Officer Dec 10, 2021 25%
W-2 Managing EmployeeCno Aug 14, 2021

Owners & managing parties with NPI records 3

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Divide Wellness CenterGeorgetown, CA, CCN 058514 Rural health clinic Operational/Managerial Control Jun 1, 2009

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Practitioners & affiliated clinicians

Practitioners 114

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 114

Affiliated clinicians 415

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 415

NPI Registry JSON

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

{
    "created_epoch": "1122508800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1790294400000",
    "number": "1972503142",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 MARSHALL WAY",
            "city": "PLACERVILLE",
            "state": "CA",
            "postal_code": "956676533",
            "telephone_number": "530-626-2763",
            "fax_number": "530-622-7853"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 MARSHALL WAY",
            "city": "PLACERVILLE",
            "state": "CA",
            "postal_code": "956676533",
            "telephone_number": "530-626-2601",
            "fax_number": "530-622-7853"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARSHALL MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-28",
        "last_updated": "2026-09-25",
        "certification_date": "2026-09-25",
        "status": "A",
        "authorized_official_last_name": "ENTWISTLE",
        "authorized_official_first_name": "MARTIN",
        "authorized_official_title_or_position": "INTERIM CEO",
        "authorized_official_telephone_number": "530-626-2868"
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "CA",
            "license": "030000059",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ZZR00254F",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "HSP40254F",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Placerville, CA

Sources for this page

Verify at the official NPI Registry.