DR. MARSHALL DEAN WEBSTER D.C. NPI 1003000415
Chiropractor in Lake City, FL
About MARSHALL WEBSTER
Marshall Webster is a provider established in Lake City, Florida and his medical specialization is chiropractor. The NPI number of Marshall Webster is 1003000415 and was assigned on August 2007. The practitioner's primary taxonomy code is 111N00000X with license number CH10056 (FL). The provider is registered as an individual and his NPI record was last updated 3 years ago.
The CLIA number of Dr. Marshall Dean Webster D.c. is 10D2086929 registered as a "physician office" facility with a CLIA Certificate of Waiver. This CLIA certificate is issued to Dr. Marshall Dean Webster D.c. to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.
| NPI | 1003000415 |
| Provider Name | DR. MARSHALL DEAN WEBSTER D.C. |
| Provider Location Address | 1478 SW SISTERS WELCOME RD LAKE CITY, FL 32025 |
| Provider Mailing Address | 1478 SW SISTERS WELCOME RD LAKE CITY, FL 32025 |
| Gender | Male |
| NPI Entity Type | Individual |
| Is Sole Proprietor? | Yes |
| Is Organization Subpart? | N/A |
| Enumeration Date | 08-29-2007 |
| Last Update Date | 02-08-2017 |
Primary Taxonomy
| Taxonomy Code | 111N00000X |
| Classification | Chiropractor |
| Type | Chiropractic Providers |
| License No. | CH10056 |
| License State | FL |
| Taxonomy Description | A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems. |
Business Address
DR. MARSHALL DEAN WEBSTER D.C.
1478 SW SISTERS WELCOME RD
LAKE CITY, FL
ZIP 32025
Phone: (386) 590-1752
Fax: (386) 269-9676
Mailing Address
DR. MARSHALL DEAN WEBSTER D.C.
1478 SW SISTERS WELCOME RD
LAKE CITY, FL
ZIP 32025
Phone: (386) 590-1752
Fax: (386) 269-9676
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for the NPI number 1003000415 is:
| CLIA Number | 10D2086929 |
| Facility Type | PHYSICIAN OFFICE |
| Certificate Type | Certificate of Waiver |
Secondary Taxonomies
The secondary taxonomy codes define the provider type, classification, and specialization. For individual NPIs the license data is associated to each taxonomy code.
| No. | Taxonomy Code | Type | Classification | Specialization | License No. | State | Primary |
|---|---|---|---|---|---|---|---|
| 1 | 111N00000X | Chiropractic Providers | Chiropractor | CHIR008295 | GA | No | |
Taxonomy Description: a provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems. | |||||||
| 2 | 111N00000X | Chiropractic Providers | Chiropractor | 3177 | SC | No | |
Taxonomy Description: a provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems. | |||||||
Additional Identifiers
Additional identifier(s) currently or formerly used as an identifier for the provider. The codes may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State |
|---|---|---|
| IA771A | MEDICARE UPIN (02) | FL |
NPI Footnotes
What is the National Provider Indentifier (NPI)?
The NPI is 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.
Provider Location Address
The location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Mailing Address
The mailing address of the provider being identified. This address may contain the same information as the provider location address.
Entity Type Code
The code describing the type of health care provider that is being assigned an NPI.
The entity type codes are:
1 = Person: individual human being who furnishes health care;
2 = Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Subparts are the components and separate physical locations of organization health care providers. Subpart examples include:
Hospital components include outpatient departments, surgical centers, psychiatric units, and laboratories. These components are often separately licensed or certified by States and may exist at physical locations other than that of the hospital of which they are a component.
Provider Other Organization Name
The other organization name is the alternative last name by which the provider is or has been known (if an individual) or other name by which the organization provider is or has been known. The code identifying the type of other name. The provider other organization name codes are:
1 = former name;
2 = professional name;
3 = doing business as (d/b/ a) name;
4 = former legal business name; :
5 = other.
Provider Enumeration Date
The date the provider was assigned a unique identifier (assigned an NPI).
Last Update Date
The date that a NPI record was last updated or changed.
Primary Taxonomy Code
The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
Authorized Official Name
The name of the person authorized to submit the NPI application or to officially change data for a health care provider.