MARSHALL MEDICAL CENTER (NPI# 1386065480) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1386065480 |
| Entity Type | Organization |
| Organization Name | MARSHALL MEDICAL CENTER |
| Other Organization Name | MARSHALL PEDIATRIC CLINIC |
| Practice Address |
4341 Golden Center Dr Suite A Placerville CA 95667-6260 |
| Mailing Address |
Po Box 45680 San Francisco CA 94145-0680 |
| Practice Telephone | 5306261144 |
| Mailing Telephone | 5306262787 |
| Enumeration Date | 2013-12-17 |
| Last Update Date | 2020-09-08 |
| Authorized Official Name | LAURIE ELDRIDGE (CEO) |
| Authorized Official Telephone | 5306262787 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 208000000X | Pediatrics | 030000059 | CA | Allopathic & Osteopathic Physicians |
| Y | 261QR1300X |
Clinic/Center Specialization: Rural Health |
CA | Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Marshall Pediatric Clinic | Doing Business As Name - Organization |
| 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 |
| 1073088316 | Marshall Medical Center | Psychiatry & Neurology | 1045 Marshall Way, Placerville, CA 95667-5721 | 2018-10-12 |
| 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 |
4341 GOLDEN CENTER DR SUITE A |
| City | PLACERVILLE |
| State | CA |
| Zip Code | 95667-6260 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558367102 | William Koble | Family Medicine | 4341 Golden Center Dr, Suite B, Placerville, CA 95667-6260 | 2005-06-27 |
| 1801336128 | Jocelyne Renee O'connor | Nurse Practitioner | 4341 Golden Center Dr, Placerville, CA 95667-6260 | 2017-03-06 |
| 1518280288 | Tonantzin Eva Rodriguez | Family Medicine | 4341 Golden Center Dr, Placerville, CA 95667-6260 | 2010-03-09 |
| 1326286048 | Marshall Medical Center | Family Medicine | 4341 Golden Center Dr, Suite B, Placerville, CA 95667-6260 | 2009-02-03 |
| 1679731889 | Courtney Ann Lacaze-adams | Pediatrics | 4341 Golden Center Dr, Suite A, Placerville, CA 95667-6260 | 2008-05-26 |
| 1487841128 | Marshall Medical | Pediatrics | 4341 Golden Center Dr, Suite A, Placerville, CA 95667 | 2007-09-26 |
| 1225168693 | Mary Louise Giska | Nurse Practitioner | 4341 Golden Center Dr, Suite B, Placerville, CA 95667-6260 | 2007-03-06 |
| 1699829184 | Marshall Center for Pediatrics | Pediatrics | 4341 Golden Center Dr, Suite A, Placerville, CA 95667-6816 | 2007-01-22 |
| 1770647299 | Peter Andrew Barba | Family Medicine | 4341 Golden Center Dr, Suite B, Placerville, CA 95667-6260 | 2006-12-20 |
| 1649383399 | Rene A. Orona | Family Medicine | 4341 Golden Center Dr, Suite B, Placerville, CA 95667-6260 | 2006-08-16 |
| Find all providers in the same location | ||||
| 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 | 261QR1300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Rural Health |
| Definition to come... |
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| 1679038434 | Ridgecrest Regional Hospital | Clinic/Center | 105 E Sydnor Ave, Ridgecrest, CA 93555-5546 | 2019-02-06 |
| Find all providers with the same taxonomy | ||||
| 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.