Active NPI
Mark Russell Heston, D.C.
- Chiropractor
- Weaverville, CA
National Provider Identifier
1063540417
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- DC0228590
- Practice address
- 425 Trinity Lake Boulevard
B
Weaverville, CA 96093 - Phone
- (530) 623-2225
- Fax
- (530) 623-2553
- NPI assigned
- Feb 28, 2007
- Last updated
- Jul 8, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | DC0228590 | CA | Primary |
Addresses
Primary practice location
425 Trinity Lake Boulevard
B
Weaverville, CA 96093
Mailing address
PO Box 1503
Weaverville, CA 96093-1503
Phone (530) 623-2225
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DC0228590 | CA | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1172620800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1063540417",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1503",
"city": "WEAVERVILLE",
"state": "CA",
"postal_code": "960931503",
"telephone_number": "530-623-2225",
"fax_number": "530-623-2553"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "425 TRINITY LAKE BOULEVARD",
"address_2": "B",
"city": "WEAVERVILLE",
"state": "CA",
"postal_code": "96093",
"telephone_number": "530-623-2225",
"fax_number": "530-623-2553"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HESTON",
"first_name": "MARK",
"middle_name": "RUSSELL",
"name_prefix": "Dr.",
"credential": "D.C.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-02-28",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "CA",
"license": "DC0228590",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Weaverville, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.