Active NPI
Mark Tyrone Nimmo, DC
- Chiropractor
- Longmont, CO
National Provider Identifier
1134314842
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 4994
- Practice address
- 420 21St Ave Ste 102
Longmont, CO 80501-1441 - Phone
- (303) 651-1400
- Fax
- (303) 776-9272
- NPI assigned
- Sep 6, 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 | 4994 | CO | Primary |
Addresses
Primary practice location
420 21St Ave Ste 102
Longmont, CO 80501-1441
Mailing address
420 21St Ave Ste 102
Longmont, CO 80501-1441
Phone (303) 651-1400
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4994 | CO | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Applied Kinesiological Group PC | Chiropractor | Past | Accepting new patients |
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 and National Provider Directory roles.
-
- Chiropractor
- Longmont, CO
- NPI 1477706760
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1189036800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1189036800000",
"number": "1134314842",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "420 21ST AVE STE 102",
"city": "LONGMONT",
"state": "CO",
"postal_code": "805011441",
"telephone_number": "303-651-1400",
"fax_number": "303-776-9272"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "420 21ST AVE STE 102",
"city": "LONGMONT",
"state": "CO",
"postal_code": "805011441",
"telephone_number": "303-651-1400",
"fax_number": "303-776-9272"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NIMMO",
"first_name": "MARK",
"middle_name": "TYRONE",
"name_prefix": "Dr.",
"credential": "DC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-09-06",
"last_updated": "2007-09-06",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "CO",
"license": "4994",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Longmont, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 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.