Jack E Marshall, MD

Primary specialty

Interventional Pain Medicine PhysicianTaxonomy code 208VP0014X

License

15252 Issued in OK

Practice address

14100 Parkway Commons Dr Ste 102
Oklahoma City, OK 73134-6036

Phone

(406) 286-9820

Fax

(405) 286-9813

NPI assigned

Jun 8, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in OK

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 Medicine

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.

• Osh Pain Management Associates, LLC

  • Interventional Pain Medicine Physician
  • Oklahoma City, OK
  • NPI 1568701332
  Medicare reassignment NPD
• Neuroscience Specialists PC

  • Neurological Surgery Physician
  • Oklahoma City, OK
  • NPI 1548239494
  NPD (past)
• Summit Medical Center

  • General Acute Care Hospital
  • Edmond, OK
  • NPI 1356574560

  Interventional Pain Medicine

  NPD (past)

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

{
    "created_epoch": "1118188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582156800000",
    "number": "1982608873",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 269031",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731269031",
            "telephone_number": "405-286-9820",
            "fax_number": "405-286-9813"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14100 PARKWAY COMMONS DR STE 102",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731346036",
            "telephone_number": "406-286-9820",
            "fax_number": "405-286-9813"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARSHALL",
        "first_name": "JACK",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-08",
        "last_updated": "2020-02-20",
        "certification_date": "2020-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "OK",
            "license": "15252",
            "primary": false
        },
        {
            "code": "208VP0014X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "OK",
            "license": "15252",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OLD MEDICARE RR",
            "identifier": "050058014",
            "state": "OK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100124480A",
            "state": "OK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RR",
            "identifier": "P00445607",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mary Ellyn Marsh, LPC
• Micheal Marsh
• Marsha Zahn, Speech Pathologist P.C.
• Candaca M Marshall, MD
• Christopher Allen Marshall
• Jennifer Marshall, LCSW
• Jessica Marshall, PA-C
• Kamaryne N Marshall
• Kelli Brooke Marshall, MS, CCC-SLP
• Kimberly Michelle Marshall

• Interventional Pain Medicine Physician in Oklahoma City, OK
• Providers in Oklahoma City, OK by specialty
• Interventional Pain Medicine Physician in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2020; 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.