MARSHALL MEDICAL CENTER (NPI# 1558645820) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1558645820 |
| Entity Type | Organization |
| Organization Name | MARSHALL MEDICAL CENTER |
| Other Organization Name | MARSHALL GENERAL SURGERY |
| Practice Address |
1095 Marshall Way Suite 202 Placerville CA 95667-5722 |
| Mailing Address |
Po Box 45680 San Francisco CA 94145-0680 |
| Practice Telephone | 5306261102 |
| Mailing Telephone | 5306261102 |
| Enumeration Date | 2011-10-05 |
| Last Update Date | 2020-09-08 |
| Authorized Official Name | MRS. LAURIE ELDRIDGE (CFO) |
| Authorized Official Telephone | 5306262770 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208600000X | Surgery | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Marshall General Surgery | Other Name - Individual/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 |
| 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 |
1095 MARSHALL WAY SUITE 202 |
| 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 |
| 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 |
| 1962506097 | Marshall Medical Center | Internal Medicine | 1095 Marshall Way, Suite 100, Placerville, CA 95667-5722 | 2006-09-11 |
| 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 | 208600000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447521406 | Robert Francis Kissling IIi | Surgery | 7040 Amber Way, Placerville, CA 95667-9043 | 2012-01-23 |
| 1649482910 | Ryan R Lussenden | Surgery | 1095 Marshall Way Ste 202, Placerville, CA 95667-5722 | 2007-05-07 |
| 1053799874 | Leighton E Belden | Surgery | 1100 Marshall Way, Placerville, CA 95667-6533 | 2015-05-13 |
| 1952742207 | John Yongkwon Lee | Surgery | 1095 Marshall Way, Suite 202, Placerville, CA 95667-5722 | 2013-07-16 |
| 1467778217 | Kathleen Mary Hertzer | Surgery | 1095 Marshall Way Ste 202, Placerville, CA 95667-5722 | 2010-04-19 |
| 1649489857 | Richard Detwiler, M.d., Inc | Surgery | 941 Spring St, Ste 1, Placerville, CA 95667-4546 | 2007-05-22 |
| 1275665812 | V. L. Grant M. D. Pmc | Surgery | 1008 Fowler Way, Suite B, Placerville, CA 95667-5701 | 2007-03-09 |
| 1861548117 | Craig R Thayer | Surgery | 941 Spring St, Suitea, Placerville, CA 95667-4546 | 2007-01-26 |
| 1952462244 | Robin L Locke | Surgery | 1095 Marshall Way, Suite 202, Placerville, CA 95667-5722 | 2006-12-12 |
| 1912949850 | Richard Detwiler | Surgery | 1095 Marshall Way, Suite 202, Placerville, CA 95667-5722 | 2006-06-12 |
| 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.