Individual provider Active NPI

Jill Marie Marshall, NP

  • Nurse Practitioner
  • Jackson, MI
National Provider Identifier
1972551414
Registry record updated Jan 7, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
4704207536 Issued in MI
Practice address
205 N East Ave
Jackson, MI 49201-1753
Phone
(517) 788-4996
Fax
(517) 796-6410
NPI assigned
May 5, 2006
Last updated
Jan 7, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 7, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 4704207536 MI Primary

Addresses

Primary practice location

205 N East Ave
Jackson, MI 49201-1753

Mailing address

Department 272801
PO Box 67000
Detroit, MI 48267-2728
Phone (517) 841-6913

Other practice location 1

7575 West Grand River
Anesthesia Department
Brighton, MI 48141
Phone (810) 844-7511

Other practice location 2

5301 East Huron River
Anesthesia Department
Ypsilanti, MI 48197
Phone (734) 712-3456

Other identifiers 4

IdentifierTypeStateIssuer
5205000MedicaidMI
4761719MedicaidMI
500029681OtherMIRR MEDICARE
5008766400OtherMIBLUE CROSS BLUE SHIELD

Other names 1

  • Jill Marie Barnes Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jmarshall455239@direct.hfhs.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040923000961 MI Practitioner - Nurse Practitioner 6305814682 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1201 E Michigan Ave
Jackson, MI 49201-1855

7845 Spring Arbor Rd
Spring Arbor, MI 49283-9785
Phone (517) 205-2580

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Sparrow Ionia Hospital CurrentSince Dec 1, 2017 Accepting new patients
Edward W. Sparrow Hospital Association CurrentSince Mar 1, 2018 Accepting new patients
Sparrow Ionia Hospital CurrentSince Dec 1, 2017 Accepting new patients
Wa Foote Memorial Hospital, Inc Nurse Practitioner CurrentSince Jan 1, 2011 Accepting new patients
Sparrow Ionia Hospital Current Accepting new patients
Edward W. Sparrow Hospital Association Current Accepting new patients
Henry Ford Pathology Current Accepting new patients
Medical Observation Services, PLLC Past Accepting new patients

Locations

8175 Reliable Pkwy
Chicago, IL 60686

2682 E Grand River Ave
East Lansing, MI 48823
Phone (517) 333-6562

3565 S State Rd
Ionia, MI 48846
Phone (616) 523-1498

550 E Washington St
Ionia, MI 48846
Phone (616) 523-1600

205 N East Ave
Jackson, MI 49201
Phone (517) 788-4730

1215 E Michigan Ave
Lansing, MI 48912
Phone (517) 336-8080

716 N Clippert St
Lansing, MI 48912
Phone (517) 253-4000

800 E Columbia St
Mason, MI 48854
Phone (517) 244-8900

Interoperability endpoints

  • Direct secure messaging: jmarshall455239@direct.hfhs.org

Organizations & group practices 8

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1146787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609977600000",
    "number": "1972551414",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "DEPARTMENT 272801",
            "address_2": "PO BOX 67000",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482672728",
            "telephone_number": "517-841-6913",
            "fax_number": "517-841-6917"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 N EAST AVE",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492011753",
            "telephone_number": "517-788-4996",
            "fax_number": "517-796-6410"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7575 West Grand River",
            "address_2": "Anesthesia Department",
            "address_purpose": "LOCATION",
            "city": "Brighton",
            "state": "MI",
            "postal_code": "48141",
            "country_code": "US",
            "telephone_number": "810-844-7511",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5301 East Huron River",
            "address_2": "Anesthesia Department",
            "address_purpose": "LOCATION",
            "city": "Ypsilanti",
            "state": "MI",
            "postal_code": "48197",
            "country_code": "US",
            "telephone_number": "734-712-3456",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MARSHALL",
        "first_name": "JILL",
        "middle_name": "MARIE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-05",
        "last_updated": "2021-01-07",
        "certification_date": "2021-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MI",
            "license": "4704207536",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5205000",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4761719",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "500029681",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "5008766400",
            "state": "MI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jmarshall455239@direct.hfhs.org",
            "affiliation": "N",
            "address_1": "1201 E. Michigan Ave",
            "address_2": "Suite 200, Pain Clinic",
            "city": "Jackson",
            "state": "MI",
            "country_code": "US",
            "postal_code": "49201",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "JILL",
            "last_name": "BARNES",
            "middle_name": "MARIE",
            "credential": "NP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Jackson, MI

Sources for this page

Verify at the official NPI Registry.