Individual provider Active NPI

Mark Ashley Hart, D.O.

  • Family Medicine Physician
  • Spokane, WA
National Provider Identifier
1013919927
Registry record updated Oct 19, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
OP00001655 Issued in WA
Practice address
107 E Holland Ave
Spokane, WA 99218-1209
Phone
(509) 466-3960
Fax
(509) 466-9566
NPI assigned
Aug 10, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 19, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X OP00001655 WA Primary

Addresses

Primary practice location

107 E Holland Ave
Spokane, WA 99218-1209

Mailing address

107 E Holland Ave
Spokane, WA 99218-1209
Phone (509) 466-3960

Other identifiers 3

IdentifierTypeStateIssuer
1124858MedicaidWA
0200957OtherWAWA DEPT OF L&I
0229080OtherWAWA DEPT OF L&I

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051019000476 WA Practitioner - Family Practice 0042235004 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Kansas City University of Med & Biosciences, College of Osteo Med, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

107 E Holland Ave
Spokane, WA 99218-1209
Phone (509) 466-3960

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
OP00001655WAMDFamily Medicine Physician
025207WAMDRehabilitation Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Hart Family Medicine PLLC Family Medicine CurrentSince Feb 1, 2008 Accepting new patients
Northpointe Family Medicine PLLC Family Medicine PastSince Oct 8, 2005 Accepting new patients
Columbia Medical Associates LLC Family Medicine Past Accepting new patients
Doctors Clinic of Spokane Family Medicine Past Accepting new patients

Locations

107 E Holland Ave
Spokane, WA 99218
Phone (509) 466-3960

Organizations & group practices 4

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": "1123632000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1255910400000",
    "number": "1013919927",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "107 E HOLLAND AVE",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992181209",
            "telephone_number": "509-466-3960",
            "fax_number": "509-466-9566"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 E HOLLAND AVE",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992181209",
            "telephone_number": "509-466-3960",
            "fax_number": "509-466-9566"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HART",
        "first_name": "MARK",
        "middle_name": "ASHLEY",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-08-10",
        "last_updated": "2009-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "OP00001655",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1124858",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WA DEPT OF L&I",
            "identifier": "0200957",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WA DEPT OF L&I",
            "identifier": "0229080",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Spokane, WA

Sources for this page

Verify at the official NPI Registry.