Individual provider Active NPI

Mark A Brown, DC

  • Chiropractor
  • Fernandina Beach, FL
National Provider Identifier
1154425486
Registry record updated Mar 8, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH0005224 Issued in FL
Practice address
5211 S Fletcher Ave
Suite 250
Fernandina Beach, FL 32034-5370
Phone
(904) 239-0449
NPI assigned
Sep 8, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 8, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CH0005224 FL Primary

Addresses

Primary practice location

5211 S Fletcher Ave
Suite 250
Fernandina Beach, FL 32034-5370

Mailing address

5211 S Fletcher Ave
Suite 250
Fernandina Beach, FL 32034-5370
Phone (904) 239-0449

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070410000532 FL Practitioner - Chiropractic 8921103565 Practice locations: Fernandina Beach, FL

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Life Chiropractic College - West, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

5422 1St Coast Hwy
Fernandina Beach, FL 32034-5423
Phone (904) 432-7607

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CH0005224FLMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Amelia Island Health & Wellness Chiropractor Current Accepting new patients
Eric a. Wiegandt, P.a. Chiropractor Past Accepting new patients
Amelia Chiropractic Clinic Chiropractor PastSince Nov 29, 2012 Accepting new patients

Locations

5422 First Coast Hwy
Fernandina Beach, FL 32034
Phone (800) 630-1002

Organizations & group practices 3

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": "1157673600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1488931200000",
    "number": "1154425486",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5211 S FLETCHER AVE",
            "address_2": "SUITE 250",
            "city": "FERNANDINA BEACH",
            "state": "FL",
            "postal_code": "320345370",
            "telephone_number": "904-239-0449"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5211 S FLETCHER AVE",
            "address_2": "SUITE 250",
            "city": "FERNANDINA BEACH",
            "state": "FL",
            "postal_code": "320345370",
            "telephone_number": "904-239-0449"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "MARK",
        "middle_name": "A",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-08",
        "last_updated": "2017-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH0005224",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fernandina Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2017; 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.