Mark V Walters DC PC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

006467 Issued in MO

Legal business name

MARK V WALTERS DC PC

Practice address

316 W Mount Vernon Blvd
Mount Vernon, MO 65712-1940

Phone

(417) 461-1155

Fax

(417) 461-1155

NPI assigned

Jun 9, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Mark Vincent Walters, DCNPI 1285794990

Title

Owner President

Phone

(417) 461-1155

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MO

Enrollment records 1

Tax ID family

Mark V Walters DC PC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Mark V. Walters DC PC

  • Chiropractor
  • Mount Vernon, MO
  • NPI 1821366550
  NPD tax ID

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Mark Vincent Walters, D.C.

  • Chiropractor
  • Mount Vernon, MO
  • NPI 1285794990
  Medicare reassignment Care Compare group NPD Authorized official
• Brandon O'Connell, DC

  • Chiropractor
  • Mount Vernon, MO
  • NPI 1902645559
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1212969600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1375833600000",
    "number": "1174783617",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "316 W MOUNT VERNON BLVD",
            "city": "MOUNT VERNON",
            "state": "MO",
            "postal_code": "657121940",
            "telephone_number": "417-461-1155",
            "fax_number": "417-461-1155"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "316 W MOUNT VERNON BLVD",
            "city": "MOUNT VERNON",
            "state": "MO",
            "postal_code": "657121940",
            "telephone_number": "417-461-1155",
            "fax_number": "417-461-1155"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARK V WALTERS DC PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-09",
        "last_updated": "2013-08-07",
        "status": "A",
        "authorized_official_last_name": "WALTERS",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "VINCENT",
        "authorized_official_title_or_position": "OWNER PRESIDENT",
        "authorized_official_telephone_number": "417-461-1155",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "MO",
            "license": "006467",
            "primary": true
        },
        {
            "code": "171100000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Acupuncturist",
            "state": "MO",
            "license": "006467",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jessica Luney, MASSAGE THERAPIST
• Lux Med Trnsport
• Cielo Marie Maca, MD
• Mary Annette Mackey, COTA/L
• Shawn W Macklin
• Mark V. Walters DC PC
• Jessica Leigh Martin
• Maximum Function Occupational Therapy LLC
• Robert Gordon McAfee, MD
• Micah Jane McHolland, OTR/L

• Chiropractor in Mount Vernon, MO
• Providers in Mount Vernon, MO by specialty
• Chiropractor in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.