Individual provider Active NPI

Mark Alan Beaty, D.C.

  • Chiropractor
  • Nederland, TX
National Provider Identifier
1023019213
Registry record updated Jan 18, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
5232 Issued in TX
Practice address
910 S Twin City Hwy
Nederland, TX 77627-4341
Phone
(409) 727-0010
Fax
(409) 727-4858
NPI assigned
Aug 10, 2005
Last updated
Jan 18, 2016By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 18, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 5232 TX Primary

Addresses

Primary practice location

910 S Twin City Hwy
Nederland, TX 77627-4341

Mailing address

910 S Twin City Hwy
Nederland, TX 77627-4341
Phone (409) 727-0010

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080929000356 TX Practitioner - Chiropractic 4880761147 Reassigns benefits to 1 organization
Practice locations: Port Neches, TX

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2721 Nall St
Suite a
Port Neches, TX 77651-5223
Phone (409) 727-0010

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Organizations & group practices 1

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

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": "1453075200000",
    "number": "1023019213",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "910 S TWIN CITY HWY",
            "city": "NEDERLAND",
            "state": "TX",
            "postal_code": "776274341",
            "telephone_number": "409-727-0010",
            "fax_number": "409-727-4858"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "910 S TWIN CITY HWY",
            "city": "NEDERLAND",
            "state": "TX",
            "postal_code": "776274341",
            "telephone_number": "409-727-0010",
            "fax_number": "409-727-4858"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEATY",
        "first_name": "MARK",
        "middle_name": "ALAN",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-08-10",
        "last_updated": "2016-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "TX",
            "license": "5232",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Nederland, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2016; 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.