NPIMap

Organization Active NPI

Marshall Medical Center

Doing business as Marshall Family Medicine El Dorado Hills

  • Family Medicine Physician
  • El Dorado Hills, CA
National Provider Identifier
1972657559
Registry record updated Sep 8, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
MARSHALL MEDICAL CENTER
Doing business as
Marshall Family Medicine El Dorado Hills
Practice address
5137 Golden Foothill Pkwy
Suite 120
El Dorado Hills, CA 95762-9670
Phone
(916) 399-8010
NPI assigned
Jan 22, 2007
Last updated
Sep 8, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 8, 2020

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

Authorized official

Name
Mrs. Laurie Eldridge
Title
Cfo
Phone
(530) 626-2770

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X CA Primary
Internal Medicine Physician 207R00000X CA

Addresses

Primary practice location

5137 Golden Foothill Pkwy
Suite 120
El Dorado Hills, CA 95762-9670

Mailing address

PO Box 45680
San Francisco, CA 94145-0680
Phone (530) 626-2787

Other practice location 1

3106 Ponte Morino Dr Ste B
Cameron Park, CA 95682-8281
Phone (530) 344-5400

Other identifiers 1

IdentifierTypeStateIssuer
CT1847OtherCARAILROAD MEDICARE

Other names 1

  • Marshall Family Medicine El Dorado Hills Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031208001095 CA Part B Supplier - Clinic/Group Practice 7517875859 Receives reassigned benefits from 169 practitioners
14 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Placerville, CA; Twin Bridges, CA; Gold River, CA; El Dorado Hills, CA; Cameron Park, CA

Other NPIs on the same Medicare enrollment 14

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 14

National Provider Directory

National Provider Directory

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)…

Practitioners & affiliated clinicians

Practitioners 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1169424000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1599523200000",
    "number": "1972657559",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 45680",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941450680",
            "telephone_number": "530-626-2787",
            "fax_number": "530-626-2839"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5137 GOLDEN FOOTHILL PKWY",
            "address_2": "SUITE 120",
            "city": "EL DORADO HILLS",
            "state": "CA",
            "postal_code": "957629670",
            "telephone_number": "916-399-8010"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3106 Ponte Morino Dr Ste B",
            "address_purpose": "LOCATION",
            "city": "Cameron Park",
            "state": "CA",
            "postal_code": "956828281",
            "country_code": "US",
            "telephone_number": "530-344-5400",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MARSHALL MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-22",
        "last_updated": "2020-09-08",
        "certification_date": "2020-09-08",
        "status": "A",
        "authorized_official_last_name": "ELDRIDGE",
        "authorized_official_first_name": "LAURIE",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "530-626-2770",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": null,
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CT1847",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Marshall Family Medicine El Dorado Hills",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Marshall Family Medicine El Dorado Hills",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in El Dorado Hills, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.