Individual provider Active NPI

Mark D Schmall, D.C.

  • Chiropractor
  • Moline, IL
National Provider Identifier
1104850445
Registry record updated May 13, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
038-006653 Issued in IL
Practice address
3816 27TH St
Moline, IL 61265-6343
Phone
(309) 797-3200
Fax
(309) 797-3255
NPI assigned
Jul 11, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 13, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X A05584 IA
Chiropractor 111N00000X 038-006653 IL Primary

Addresses

Primary practice location

3816 27TH St
Moline, IL 61265-6343

Mailing address

3816 27TH St
Moline, IL 61265-6343
Phone (309) 797-3200

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171004001749 IA Practitioner - Chiropractic 2062467673 Practice locations: Davenport, IA

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
National College of Chiropractic, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

4915 Utica Ridge Rd
Davenport, IA 52807-3063
Phone (563) 484-7806

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
A05584IAMDChiropractor
038-006653ILMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Dr. Jackie Jiang Counseling & Evaluation, LLC Past Accepting new patients
Tri-Med Health & Wellness Center, PC Chiropractor PastSince Jan 1, 2003 Accepting new patients
Healthy Life Chiropractic PC Chiropractor PastSince Jan 3, 1992 Accepting new patients
Maximum Health and Fitness Inc Chiropractor PastSince Sep 19, 2006 Accepting new patients

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": "1152576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1368403200000",
    "number": "1104850445",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3816 27TH ST",
            "city": "MOLINE",
            "state": "IL",
            "postal_code": "612656343",
            "telephone_number": "309-797-3200",
            "fax_number": "309-797-3255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3816 27TH ST",
            "city": "MOLINE",
            "state": "IL",
            "postal_code": "612656343",
            "telephone_number": "309-797-3200",
            "fax_number": "309-797-3255"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHMALL",
        "first_name": "MARK",
        "middle_name": "D",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-11",
        "last_updated": "2013-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IA",
            "license": "A05584",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038-006653",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Moline, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2013; 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.