Individual provider Active NPI

Mark Thomas Stoebe, DC

  • Chiropractor
  • Great Falls, MT
National Provider Identifier
1174621171
Registry record updated Sep 25, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
473 Issued in MT
Practice address
400 13TH Ave S
Ste 104
Great Falls, MT 59405
Phone
(406) 727-1660
Fax
(406) 452-9094
NPI assigned
Sep 21, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 473 MT Primary

Addresses

Primary practice location

400 13TH Ave S
Ste 104
Great Falls, MT 59405

Mailing address

400 13TH Ave S
Ste 104
Great Falls, MT 59405
Phone (406) 727-1660

Other identifiers 2

IdentifierTypeStateIssuer
0160641MedicaidMT
MSF0059378OtherMTSTTE FUND

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060310000408 MT Practitioner - Chiropractic 2466469804 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Logan College of Chiropractic, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Great Falls Chiropractic Clinic PLLCGroup PAC ID 2961419304, 2 clinicians

Practice addresses (Care Compare)

400 13TH Ave S
Suite 104
Great Falls, MT 59405-4300
Phone (406) 727-1660

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
473MTMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Great Falls Chiropractic Clinic, P.L.L.C CurrentSince Dec 29, 2005 Accepting new patients

Locations

400 13th Ave S
Ste 104
Great Falls, MT 59405
Phone (406) 727-1660

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.

NPI Registry JSON

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

{
    "created_epoch": "1158796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1380067200000",
    "number": "1174621171",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 13TH AVE S",
            "address_2": "STE 104",
            "city": "GREAT FALLS",
            "state": "MT",
            "postal_code": "59405",
            "telephone_number": "406-727-1660",
            "fax_number": "406-452-9094"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 13TH AVE S",
            "address_2": "STE 104",
            "city": "GREAT FALLS",
            "state": "MT",
            "postal_code": "59405",
            "telephone_number": "406-727-1660",
            "fax_number": "406-452-9094"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STOEBE",
        "first_name": "MARK",
        "middle_name": "THOMAS",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-21",
        "last_updated": "2013-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MT",
            "license": "473",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0160641",
            "state": "MT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STTE FUND",
            "identifier": "MSF0059378",
            "state": "MT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Great Falls, MT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 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.