WILLIAM R MARSHALL MD PA (NPI# 1396887204) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1396887204 |
| Entity Type | Organization |
| Organization Name | WILLIAM R MARSHALL MD PA |
| Practice Address |
1034 Mar Walt Dr Ste 100 Fort Walton Beach FL 32547-6645 |
| Practice Telephone | 8508632153 |
| Practice Fax Number | 8503159350 |
| Mailing Telephone | 8508632153 |
| Mailing Fax Number | 8503159350 |
| Enumeration Date | 2007-02-14 |
| Last Update Date | 2008-05-30 |
| Authorized Official Name | DR. WILLIAM R MARSHALL (PHYSICIAN) |
| Authorized Official Telephone | 8508632153 |
| Authorized Official Credential | MD PA |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207XX0005X |
Orthopaedic Surgery Specialization: Sports Medicine |
ME35510 | FL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | RR MEDICARE | 406203902 | 01 |
| FL | RR MEDICARE GROUP | DE9184 | 01 |
| Street Address |
1034 MAR WALT DR STE 100 |
| City | FORT WALTON BEACH |
| State | FL |
| Zip Code | 32547-6645 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952305484 | Theodore I Macey | Orthopaedic Surgery | 1034 Mar Walt Dr Ste 100, Fort Walton Beach, FL 32547-6645 | 2005-06-13 |
| 1861658338 | John C Warburton Md Pa | Orthopaedic Surgery | 1034 Mar Walt Dr Ste 100, Fort Walton Beach, FL 32547-6645 | 2008-08-04 |
| 1528100088 | Joseph R Agostinelli Dpm Pa | Podiatrist | 1034 Mar Walt Dr Ste 100, Fort Walton Beach, FL 32547-6645 | 2007-02-13 |
| 1336281773 | Mark J Tenholder Md Pa | Orthopaedic Surgery | 1034 Mar Walt Dr Ste 100, Fort Walton Beach, FL 32547-6645 | 2007-02-13 |
| 1568504173 | Jason W Thackeray Md Pa | Orthopaedic Surgery | 1034 Mar Walt Dr Ste 100, Fort Walton Beach, FL 32547-6645 | 2007-02-12 |
| 1174665830 | Theodore I Macey Md Pa | Orthopaedic Surgery | 1034 Mar Walt Dr Ste 100, Fort Walton Beach, FL 32547-6645 | 2007-02-12 |
| 1033114426 | William R Marshall | Orthopaedic Surgery | 1034 Mar Walt Dr Ste 100, Fort Walton Beach, FL 32547-6645 | 2005-06-14 |
| 1932103397 | Joseph R Agostinelli | Podiatrist | 1034 Mar Walt Dr Ste 100, Fort Walton Beach, FL 32547-6645 | 2005-06-13 |
| 1407850878 | Mark J Tenholder | Orthopaedic Surgery | 1034 Mar Walt Dr Ste 100, Fort Walton Beach, FL 32547-6645 | 2005-06-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255944955 | Theresa Ann Morvay | Behavior Technician | 419 Racetrack Rd Ne, Fort Walton Beach, FL 32547 | 2020-08-24 |
| 1588295422 | Emily Ann Glossop | Nurse Practitioner | 930 Mar Walt Drive C, Fort Walton Beach, FL 32547 | 2020-01-29 |
| 1225669443 | Elizabeth Rogers Nagengast | Physician Assistant | 930 Mar Walt Drive, Unit C, Fort Walton Beach, FL 32547 | 2020-01-27 |
| 1497254791 | Carmen Alston | Nurse Practitioner | 930 Mar Walt Dr C, Fort Walton Beach, FL 32547 | 2018-02-02 |
| 1871004960 | Center for Neuropsychological Services Cns | Clinical Neuropsychologist | 1817 Lewis Turner Blvd, Fort Walton Beach, FL 32547 | 2017-10-17 |
| 1194235648 | Robin Wray | Speech-Language Pathologist | 930 Mar Walt Dr D, Fort Walton Beach, FL 32547 | 2017-10-10 |
| 1285007989 | Dynamic Pain & Wellness Pllc | Pain Medicine | 930 Marwalt Drive, Suite B and C, Fort Walton Beach, FL 32547 | 2015-11-04 |
| 1013392810 | Terry Abbott | Social Worker | 648 Overbrook Dr, Fort Walton Beach, FL 32547 | 2015-07-22 |
| 1083024673 | Emily Lohr | Physical Therapy Assistant | 2000 Principle Ln, Ft. Walton Beach, FL 32547 | 2014-05-05 |
| 1831526102 | Laurie Ann Schweppe | Nurse Practitioner | 1005 Mar Walt Drivve, Snf Hospitalist Department, Fort Walton Beach, FL 32547 | 2013-10-02 |
| Find all providers in zip 32547 | ||||
| Taxonomy Code | 207XX0005X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Orthopaedic Surgery |
| Specialization | Sports Medicine |
| An orthopaedic surgeon trained in sports medicine provides appropriate care for all structures of the musculoskeletal system directly affected by participation in sporting activity. This specialist is proficient in areas including conditioning, training and fitness, athletic performance and the impact of dietary supplements, pharmaceuticals, and nutrition on performance and health, coordination of care within the team setting utilizing other health care professionals, field evaluation and management, soft tissue biomechanics and injury healing and repair. Knowledge and understanding of the principles and techniques of rehabilitation, athletic equipment and orthotic devices enables the specialist to prevent and manage athletic injuries. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton changed, source changed] Additional Resources: American Board of Orthopaedic Surgery, 2007. http://www.abos.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Orthopaedic Surgery. ACGME Accredited Program Requirements: 1 year GME in the specialty + 5 years of Orthopaedic Surgery for a total of 6 years |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730740218 | Baptist Physician Group LLC | Orthopaedic Surgery | 133 Racetrack Rd Nw, Fort Walton Beach, FL 32547-1644 | 2019-06-25 |
| 1336281773 | Mark J Tenholder Md Pa | Orthopaedic Surgery | 1034 Mar Walt Dr Ste 100, Fort Walton Beach, FL 32547-6645 | 2007-02-13 |
| 1568504173 | Jason W Thackeray Md Pa | Orthopaedic Surgery | 1034 Mar Walt Dr Ste 100, Fort Walton Beach, FL 32547-6645 | 2007-02-12 |
| 1174665830 | Theodore I Macey Md Pa | Orthopaedic Surgery | 1034 Mar Walt Dr Ste 100, Fort Walton Beach, FL 32547-6645 | 2007-02-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801401021 | Ortho Florida, LLC | Orthopaedic Surgery | 17425 7th St Ste 560174, Montverde, FL 34756-3206 | 2020-09-14 |
| 1801429022 | Ortho Florida, LLC | Orthopaedic Surgery | 2122 W Cypress Creek Rd Ste 202, Ft Lauderdale, FL 33309-1858 | 2020-02-17 |
| 1750913141 | Tyrance Orthopedics and Sports Medicine | Orthopaedic Surgery | 1620 S Congress Ave Ste 201, Palm Springs, FL 33461-2128 | 2020-02-04 |
| 1255979076 | Ortho Florida, LLC | Orthopaedic Surgery | 2122 W Cypress Crk Rd Ste 202, Fort Lauderdale, FL 33309-1858 | 2019-12-11 |
| 1164984720 | Ortho Florida, LLC | Orthopaedic Surgery | 21097 Ne 27th Ct Ste 590, Aventura, FL 33180-1246 | 2019-04-03 |
| 1578043998 | Bahri Orthopedics Institute | Orthopaedic Surgery | 6100 Kennerly Rd Ste 202, Jacksonville, FL 32216-4379 | 2018-08-15 |
| 1154834489 | Dorothy Richardson | Orthopaedic Surgery | 1120 W Lakeshore Dr, Clermont, FL 34711-2936 | 2017-11-08 |
| 1225541790 | Ortho Florida, LLC | Orthopaedic Surgery | 3702 Washington St Ste 202, Hollywood, FL 33021-8283 | 2017-11-07 |
| 1275046831 | Galaxy Wellness Sport and Rehabilitation Center LLC | Orthopaedic Surgery | 1951 Nw 7th St, Miami, FL 33125 | 2017-11-06 |
| 1770004152 | Ortho Florida, LLC | Orthopaedic Surgery | 9195 Sunset Dr Ste 100, Miami, FL 33173-3488 | 2017-07-06 |
| Find all providers with the same taxonomy | ||||
| City | FORT WALTON BEACH |
| Zip Code | 32547 |
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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.