MARSHALL MEDICAL CENTER (NPI# 1962506097) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1962506097 |
| Entity Type | Organization |
| Organization Name | MARSHALL MEDICAL CENTER |
| Other Organization Name | MARSHALL FAMILY MEDICINE PLACERVILLE |
| Practice Address |
1095 Marshall Way Suite 100 Placerville CA 95667-5722 |
| Mailing Address |
Po Box 45680 San Francisco CA 94145-0680 |
| Practice Telephone | 5306262920 |
| Mailing Telephone | 5306262920 |
| Enumeration Date | 2006-09-11 |
| Last Update Date | 2020-09-08 |
| Authorized Official Name | MRS. SIRI NELSON (CEO) |
| Authorized Official Telephone | 5306262601 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207R00000X | Internal Medicine | CA | Allopathic & Osteopathic Physicians | |
| N | 207RG0100X |
Internal Medicine Specialization: Gastroenterology |
Allopathic & Osteopathic Physicians | ||
| N | 2084P0800X |
Psychiatry & Neurology Specialization: Psychiatry |
CA | Allopathic & Osteopathic Physicians | |
| Y | 207Q00000X | Family Medicine | CA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | RAILROAD MEDICARE | CT1847 | 01 |
| Other Name | Type Code |
|---|---|
| Marshall Family Medicine Placerville | 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 |
| 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 |
| 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 |
1095 MARSHALL WAY SUITE 100 |
| City | PLACERVILLE |
| State | CA |
| Zip Code | 95667-5722 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043210123 | Jonathan Lehrman | Family Medicine | 1095 Marshall Way, Placerville, CA 95667-5722 | 2005-07-29 |
| 1952742207 | John Yongkwon Lee | Surgery | 1095 Marshall Way, Suite 202, Placerville, CA 95667-5722 | 2013-07-16 |
| 1558645820 | Marshall Medical Center | Surgery | 1095 Marshall Way, Suite 202, Placerville, CA 95667-5722 | 2011-10-05 |
| 1679800247 | Samuel J W Ceridon | Family Medicine | 1095 Marshall Way, Placerville, CA 95667-5722 | 2009-11-03 |
| 1427287077 | Courtnie Billett | Family Medicine | 1095 Marshall Way, Placerville, CA 95667-5722 | 2009-07-03 |
| 1346413820 | Robert Edward Carter | Obstetrics & Gynecology | 1095 Marshall Way, Suite 201, Placerville, CA 95667-5722 | 2008-04-07 |
| 1174791743 | Kathryn Ann Sullivan | Nurse Practitioner | 1095 Marshall Way, 2nd Floor, Placerville, CA 95667-5722 | 2008-02-15 |
| 1609062389 | Marshall Medical Center | Obstetrics & Gynecology | 1095 Marshall Way, Suite 201, Placerville, CA 95667-5722 | 2007-09-17 |
| 1952462244 | Robin L Locke | Surgery | 1095 Marshall Way, Suite 202, Placerville, CA 95667-5722 | 2006-12-12 |
| 1386669638 | Phyllis V Allen | Nurse Practitioner | 1095 Marshall Way, Placerville, CA 95667-5722 | 2006-07-13 |
| 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 | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457526972 | Emilie Beth Riddle | Family Medicine | 1095 Marshall Way Ste 100, Placerville, CA 95667-5722 | 2008-04-25 |
| 1609953256 | Keith J Boston | Family Medicine | 3150 Gilmore St, Placerville, CA 95667-5500 | 2006-11-01 |
| 1457457160 | H Lynn Drummer | Family Medicine | 652 Main St, Placerville, CA 95667-5704 | 2006-09-16 |
| 1508884073 | Placerville Family Practice Medical Group, Inc | Family Medicine | 905 Spring St, Placerville, CA 95667-4511 | 2006-07-17 |
| 1962465104 | David F Ramos | Family Medicine | 3105 Cedar Ravine Rd, Suite 103, Placerville, CA 95667-6561 | 2006-04-10 |
| 1043210123 | Jonathan Lehrman | Family Medicine | 1095 Marshall Way, Placerville, CA 95667-5722 | 2005-07-29 |
| 1558367102 | William Koble | Family Medicine | 4341 Golden Center Dr, Suite B, Placerville, CA 95667-6260 | 2005-06-27 |
| 1427052257 | Paul Bernard Sobelman | Family Medicine | 1000 Fowler Way, Ste 7, Placerville, CA 95667-5738 | 2005-06-09 |
| 1730529439 | Michael Ngo | Family Medicine | 4327 Golden Center Dr, El Dorado Community Health Center, Placerville, CA 95667-6287 | 2013-06-27 |
| 1487097929 | Loni D Jay | Family Medicine | 1045 Marshall Way, Placerville, CA 95667-5721 | 2013-04-15 |
| Find all providers in PLACERVILLE | ||||
| 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.