Individual provider Active NPI

Mark Jacob Sehnert, D.C.

  • Chiropractor
  • Florissant, MO
National Provider Identifier
1205004462
Registry record updated May 22, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2008000268 Issued in MO
Practice address
869 Saint Francois St
Florissant, MO 63031-4923
Phone
(314) 839-8884
Fax
(314) 839-8891
NPI assigned
Feb 11, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 22, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 2008000268 MO Primary

Addresses

Primary practice location

869 Saint Francois St
Florissant, MO 63031-4923

Mailing address

26421 Southfield Rd
Lathrup Village, MI 48076-4528
Phone (248) 905-5066

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080415000447 MO Practitioner - Chiropractic 9739267865 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Logan College of Chiropractic, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

745 Rue Saint Francois
Florissant, MO 63031-4921
Phone (314) 839-8884

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2008000268MOMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Epic Life Chiropractic & Wellness LLC Chiropractor CurrentSince May 20, 2016 Accepting new patients

Locations

26421 Southfield Rd
Lathrup Village, MI 48076
Phone (248) 905-5066

745 Rue Saint Francois St
Florissant, MO 63031
Phone (314) 839-8884

869 Rue Saint Francois St
Florissant, MO 63031
Phone (314) 329-3675

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": "1202688000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1432252800000",
    "number": "1205004462",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26421 SOUTHFIELD RD",
            "city": "LATHRUP VILLAGE",
            "state": "MI",
            "postal_code": "480764528",
            "telephone_number": "248-905-5066",
            "fax_number": "248-905-5069"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "869 SAINT FRANCOIS ST",
            "city": "FLORISSANT",
            "state": "MO",
            "postal_code": "630314923",
            "telephone_number": "314-839-8884",
            "fax_number": "314-839-8891"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEHNERT",
        "first_name": "MARK",
        "middle_name": "JACOB",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-02-11",
        "last_updated": "2015-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MO",
            "license": "2008000268",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Florissant, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2015; 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.