Individual provider Active NPI

Mark Douglas McClure, D.C.

  • Chiropractor
  • Middletown, OH
National Provider Identifier
1164458964
Registry record updated Aug 22, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
1192 Issued in OH
Practice address
182 N Breiel Blvd
Suite a
Middletown, OH 45042-3802
Phone
(513) 423-7855
Fax
(513) 422-4103
NPI assigned
Jun 23, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 1192 OH Primary

Addresses

Primary practice location

182 N Breiel Blvd
Suite a
Middletown, OH 45042-3802

Mailing address

182 N Breiel Blvd
Suite a
Middletown, OH 45042-3802
Phone (513) 423-7855

Other identifiers 1

IdentifierTypeStateIssuer
0950958MedicaidOH

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

LicenseStateTypeSpecialty
1192OHMDChiropractor
901NMMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
The Pain Management Clinic LLC PastSince Jan 29, 2007 Accepting new patients
Santa Maria P.C. Dba Caremore Chiropractic Centers Chiropractor PastSince May 20, 1996 Accepting new patients

Organizations & group practices 2

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": "1151020800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1313971200000",
    "number": "1164458964",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "182 N BREIEL BLVD",
            "address_2": "SUITE A",
            "city": "MIDDLETOWN",
            "state": "OH",
            "postal_code": "450423802",
            "telephone_number": "513-423-7855",
            "fax_number": "513-422-4103"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "182 N BREIEL BLVD",
            "address_2": "SUITE A",
            "city": "MIDDLETOWN",
            "state": "OH",
            "postal_code": "450423802",
            "telephone_number": "513-423-7855",
            "fax_number": "513-422-4103"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCLURE",
        "first_name": "MARK",
        "middle_name": "DOUGLAS",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-23",
        "last_updated": "2011-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "OH",
            "license": "1192",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0950958",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Middletown, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.