Individual provider Active NPI

Mark Richard Hembree, D.C.

  • Chiropractor
  • Tyler, TX
National Provider Identifier
1003887548
Registry record updated Aug 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2859 Issued in TX
Practice address
2004 W Grande Blvd
Tyler, TX 75703-0537
Phone
(903) 561-0086
Fax
(903) 561-2576
NPI assigned
Feb 1, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 2859 TX Primary

Addresses

Primary practice location

2004 W Grande Blvd
Tyler, TX 75703-0537

Mailing address

2004 W Grande Blvd
Tyler, TX 75703-0537
Phone (903) 561-0086

Other identifiers 2

IdentifierTypeStateIssuer
001161102MedicaidTX
8R6370OtherTXBCBS OF TEXAS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040707000162 TX Practitioner - Chiropractic 9133106214 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hembree Chiropractic PAGroup PAC ID 7618928326, 5 clinicians

Practice addresses (Care Compare)

2004 W Grande Blvd
Tyler, TX 75703-0537
Phone (903) 561-0086

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2859TXMDMarriage & Family Therapist

Practice roles (2 of 3)

OrganizationSpecialtyStatusNew patients
Hembree Chiropractic PA Chiropractor CurrentSince Jan 1, 2005 Accepting new patients
Cody a Carter DC Chiropractor Past Accepting new patients

Locations

1904 W Grande Blvd
Tyler, TX 75703
Phone (903) 561-0086

2004 W Grande Blvd
Tyler, TX 75703
Phone (903) 561-0086

212 Grande Blvd
Ste B220
Tyler, TX 75703
Phone (903) 561-0086

Networks

  • NM HMO C-SNP

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1138752000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723680000000",
    "number": "1003887548",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2004 W GRANDE BLVD",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757030537",
            "telephone_number": "903-561-0086",
            "fax_number": "903-561-2576"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2004 W GRANDE BLVD",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757030537",
            "telephone_number": "903-561-0086",
            "fax_number": "903-561-2576"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEMBREE",
        "first_name": "MARK",
        "middle_name": "RICHARD",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-01",
        "last_updated": "2024-08-15",
        "certification_date": "2024-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "TX",
            "license": "2859",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001161102",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF TEXAS",
            "identifier": "8R6370",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tyler, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.