MARSHALL MEDICAL CENTER (NPI# 1073088316) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1073088316 |
| Entity Type | Organization |
| Organization Name | MARSHALL MEDICAL CENTER |
| Practice Address |
1045 Marshall Way Placerville CA 95667-5721 |
| Mailing Address |
Po Box 45680 San Francisco CA 94145-0680 |
| Practice Telephone | 5306228204 |
| Practice Fax Number | 5306228205 |
| Mailing Telephone | 5306262787 |
| Enumeration Date | 2018-10-12 |
| Last Update Date | 2020-09-08 |
| Authorized Official Name | LAURIE ELDRIDGE (CFO) |
| Authorized Official Telephone | 5306221441 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 2084N0400X |
Psychiatry & Neurology Specialization: Neurology |
Allopathic & Osteopathic Physicians | ||
| N | 2084P0800X |
Psychiatry & Neurology Specialization: Psychiatry |
Allopathic & Osteopathic Physicians | ||
| Y | 207QA0401X |
Family Medicine Specialization: Addiction Medicine |
Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | ZZZ00439Z | 05 |
| Other Name | Type Code |
|---|---|
| Marshall CARES | Doing Business As Name - Organization |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 3581 Palmer Dr Ste 202, Cameron Park, CA 956828237 | 5306727000 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346226693 | Marshall Medical Center | Clinic/Center | 6065 State Hwy 193, Georgetown, CA 95634-9623 | 2005-12-19 |
| 1356904577 | Marshall Medical Center | Clinic/Center | 3581 Palmer Dr Ste 202, Cameron Park, CA 95682-8237 | 2019-04-15 |
| 1386065480 | Marshall Medical Center | Pediatrics | 4341 Golden Center Dr, Suite A, Placerville, CA 95667-6260 | 2013-12-17 |
| 1558645820 | Marshall Medical Center | Surgery | 1095 Marshall Way, Suite 202, Placerville, CA 95667-5722 | 2011-10-05 |
| 1649562315 | Marshall Medical Center | Orthopaedic Surgery | 4300 Golden Center Dr, Suite C, Placerville, CA 95667-6278 | 2011-05-12 |
| 1578872784 | Marshall Medical Center | Otolaryngology | 4300 Golden Center Dr, Suite D, Placerville, CA 95667-6278 | 2010-10-05 |
| 1326286048 | Marshall Medical Center | Family Medicine | 4341 Golden Center Dr, Suite B, Placerville, CA 95667-6260 | 2009-02-03 |
| 1215181664 | Marshall Medical Center | Urology | 1004 Fowler Way, Suite 4, Placerville, CA 95667-5746 | 2008-11-12 |
| 1659554285 | Marshall Medical Center | Internal Medicine | 3581 Palmer Dr, Suite 400, Cameron Park, CA 95682-8236 | 2007-12-05 |
| 1609062389 | Marshall Medical Center | Obstetrics & Gynecology | 1095 Marshall Way, Suite 201, Placerville, CA 95667-5722 | 2007-09-17 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | MARSHALL MEDICAL CENTER FAMILY | 1600 Medical Center Dr Ste 1400, Huntington, WV 25701-3657 |
| Street Address |
1045 MARSHALL WAY |
| City | PLACERVILLE |
| State | CA |
| Zip Code | 95667-5721 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174525331 | Ike Himayat Rahimi | Dentist | 1045 Marshall Way, Placerville, CA 95667-5721 | 2005-06-01 |
| 1487097929 | Loni D Jay | Family Medicine | 1045 Marshall Way, Placerville, CA 95667-5721 | 2013-04-15 |
| 1073657367 | Juliet La Mers | Emergency Medicine | 1045 Marshall Way, Placerville, CA 95667-5721 | 2007-02-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053919258 | Lacey Etienne Neufeld | Nurse Practitioner | Marshall Transitional Care Unit, 1100 Marshall Way, Placerville, CA 95667 | 2020-10-12 |
| 1497390041 | Summitview Child & Family Services, Inc. | Community Based Residential Treatment Facility, Mental Illness | 3025 Glee Ln, Placerville, CA 95667 | 2019-11-07 |
| 1225694474 | Camille Borba | Doula | 1212 Lotus Rd, Placerville, CA 95667 | 2019-05-14 |
| 1033610399 | Julie Marie Halsall | Counselor | 2844 Coloma Street, Placerville, CA 95667 | 2018-02-22 |
| 1053839092 | County of El Dorado | Community/Behavioral Health | 3057 Briw Road, Suite A, Placerville, CA 95667 | 2017-08-30 |
| 1982129508 | Brent Charles Ulrici | Counselor | 2986 Colma St, Placerville, CA 95667 | 2017-08-04 |
| 1629464326 | Crystal Coury | Counselor | 5607 Mount Murphy Roas, Garden Valley, CA 95667 | 2015-04-09 |
| 1396141750 | Brown and Ghazal Dental Corporation | Dentist | 3967 Missouri Flat Road, Suite 120, Placerville, CA 95667 | 2014-11-13 |
| 1962808402 | Laura Ann Curry | Counselor | 6765 Green Valley Road, Placerville, CA 95667 | 2014-11-11 |
| 1518374453 | Kelly Lynn Carson | Counselor | 2844 Colona St., Placerville, CA 95667 | 2014-07-11 |
| Find all providers in zip 95667 | ||||
| Taxonomy Code | 207QA0401X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Specialization | Addiction Medicine |
| A family medicine physician who specializes in the diagnosis and treatment of addictions. |
| Notes: Source: National Uniform Claim Committee, 2009 [1/1/2010: definition added, source added] Additional Resources: A Certification of Added Qualifications (CAQ) was, but is no longer issued by the American Osteopathic Board of Family Physicians. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467549030 | Paul Michael Nerz | Family Medicine | 4327 Golden Center Dr, Placerville, CA 95667-6287 | 2006-10-06 |
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| City | PLACERVILLE |
| Zip Code | 95667 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.