Individual provider Active NPI

Mark A Kestner, DC

  • Chiropractor
  • Murfreesboro, TN
National Provider Identifier
1194884445
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC 598 Issued in TN
Practice address
1435 NW Broad St
Murfreesboro, TN 37129-1707
Phone
(615) 895-1253
Fax
(615) 895-1219
NPI assigned
Dec 6, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X DC 598 TN Primary

Addresses

Primary practice location

1435 NW Broad St
Murfreesboro, TN 37129-1707

Mailing address

1435 NW Broad St
Murfreesboro, TN 37129-1707
Phone (615) 895-1253

Other identifiers 2

IdentifierTypeStateIssuer
2005150OtherTNBLUE CROSS BLUE SHIELD
9499090OtherTNCIGNA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20071004000860 TN Practitioner - Chiropractic 0749375798 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Logan College of Chiropractic, 1988
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1435 NW Broad St
Murfreesboro, TN 37129-1707

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DC 598TNMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Dr. Mark Kestner Group Chiropractor CurrentSince May 20, 2013 Accepting new patients

Locations

1435 NW Broad St
Murfreesboro, TN 37129
Phone (615) 895-1235

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": "1165363200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1194884445",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1435 NW BROAD ST",
            "city": "MURFREESBORO",
            "state": "TN",
            "postal_code": "371291707",
            "telephone_number": "615-895-1253",
            "fax_number": "615-895-1219"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1435 NW BROAD ST",
            "city": "MURFREESBORO",
            "state": "TN",
            "postal_code": "371291707",
            "telephone_number": "615-895-1253",
            "fax_number": "615-895-1219"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KESTNER",
        "first_name": "MARK",
        "middle_name": "A",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-06",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "TN",
            "license": "DC 598",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "2005150",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "9499090",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Murfreesboro, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.