Mark Read Shuttleworth, DC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

0753 Issued in MS

Practice address

665 East Pass Rd Ste 3
Gulfport, MS 39507

Phone

(228) 896-3002

NPI assigned

Nov 15, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MS

Enrollment records 1

Specialty

Chiropractic

Education

Logan College of Chiropractic, 1986

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Jernigan Chiropractic Clinic IncGroup PAC ID 6103895545, 6 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Networks

• LA PPO C-SNP

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.

• Jernigan Chiropractic Clinic Inc

  • Multi-Specialty Clinic/Center
  • Gulfport, MS
  • NPI 1275701781

  Chiropractor

  Medicare reassignment Care Compare group NPD
• Shuttleworth Chiropractic Centre PA

  • Chiropractor
  • Gulfport, MS
  • NPI 1609948397
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1163548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1516060800000",
    "number": "1083786768",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "665 E PASS RD STE 3",
            "city": "GULFPORT",
            "state": "MS",
            "postal_code": "39507",
            "telephone_number": "228-896-3002",
            "fax_number": "228-897-1417"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "665 EAST PASS RD STE 3",
            "city": "GULFPORT",
            "state": "MS",
            "postal_code": "39507",
            "telephone_number": "228-896-3002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHUTTLEWORTH",
        "first_name": "MARK",
        "middle_name": "READ",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-15",
        "last_updated": "2018-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MS",
            "license": "0753",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00115351",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Cynthia B. Shields, PT
• Donald W Shinskie, CRNA
• Sheila Lee Shipman, IDC
• Joseph P. Shrum, MD
• Shuttleworth Chiropractic Centre PA
• Brittany Sick, RN
• Ibis D. Sigas, M.D.
• Carolyn C Signorine, OTR/L, CHT
• Haylee Sikes
• Silent Night Sleep Institute, LLC

• Chiropractor in Gulfport, MS
• Providers in Gulfport, MS by specialty
• Chiropractor in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2018; 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.