Marcus K Showalter
Individual provider Active NPI Counselor · University, MS
NPI 1982928503 · NPPES record last updated Mar 25, 2010
Key facts
- NPI
- 1982928503
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Counselor 101Y00000X
- License
- 359 (MS)
- Practice address
- All American Drive
University, MS 38677 - Phone
- (662) 915-3784
- Fax
- (662) 915-7831
- NPI assigned
- Mar 25, 2010
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
- Opted out of Medicare
- Yes, effective Mar 24, 2025 through Mar 24, 2027
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 359 | MS | MD | Counselor |
| 0359 | MS | MD | Registered Dietitian |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | 359 | MS | Yes |
Addresses
Primary practice location
All American Drive
University, MS 38677
Mailing address
All American Drive
University, MS 38677
Phone (662) 915-3784
Other providers in University, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 25, 2010. 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.
- Order and Referring (CMS).
- Opt Out Affidavits (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.