Individual provider Active NPI

Marty Clyde Lovvorn, D.C.

  • Rehabilitation Chiropractor
  • Birmingham, AL
National Provider Identifier
1194082180
Registry record updated May 17, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation ChiropractorTaxonomy code 111NR0400X
License
2366 Issued in AL
Practice address
104 Owens Pkwy
Suite a
Birmingham, AL 35244-1657
Phone
(205) 988-9848
NPI assigned
Apr 16, 2012
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 17, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Chiropractor 111NR0400X 2366 AL Primary

Addresses

Primary practice location

104 Owens Pkwy
Suite a
Birmingham, AL 35244-1657

Mailing address

102 Bowling LN
Pelham, AL 35124-4353
Phone (205) 988-9848

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120710000725 AL Practitioner - Chiropractic 6305001702 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Precision Chiropractic and Rehabilitation, PCGroup PAC ID 8224293626, 3 clinicians

Practice addresses (Care Compare)

102 Bowling LN
Pelham, AL 35124-4353
Phone (205) 988-9848

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2366ALMDOccupational Therapist

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": "1334534400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1558051200000",
    "number": "1194082180",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 BOWLING LN",
            "city": "PELHAM",
            "state": "AL",
            "postal_code": "351244353",
            "telephone_number": "205-988-9848",
            "fax_number": "205-998-9897"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 OWENS PKWY",
            "address_2": "SUITE A",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352441657",
            "telephone_number": "205-988-9848"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOVVORN",
        "first_name": "MARTY",
        "middle_name": "CLYDE",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-04-16",
        "last_updated": "2019-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NR0400X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Rehabilitation",
            "state": "AL",
            "license": "2366",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Birmingham, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2019; 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.