NPIMap

Organization Active NPI

Mark Balderston DC PA

  • Chiropractor
  • Shawnee, KS
National Provider Identifier
1205877040
Registry record updated Dec 21, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
01-03482 Issued in KS
Legal business name
MARK BALDERSTON DC PA
Doing business as
Mark Balderston DC PA
Practice address
6308 Monrovia St
Shawnee, KS 66216-1107
Phone
(913) 631-8888
Fax
(913) 962-1627
NPI assigned
Jun 10, 2006
Last updated
Dec 21, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 21, 2010

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

Authorized official

Name
Dr. Mark S Balderston, D.C.NPI 1629061858
Title
Chiropractor
Phone
(913) 631-8888

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 01-03482 KS Primary

Addresses

Primary practice location

6308 Monrovia St
Shawnee, KS 66216-1107

Mailing address

6308 Monrovia St
Shawnee, KS 66216-2740
Phone (913) 631-8888

Other names 1

  • MARK BALDERSTON DC PA Doing business as

National Provider Directory

National Provider Directory

Locations

11015 W 75th St
Shawnee, KS 66214
Phone (913) 631-8866

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1149897600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1292889600000",
    "number": "1205877040",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6308 MONROVIA ST",
            "city": "SHAWNEE",
            "state": "KS",
            "postal_code": "662162740",
            "telephone_number": "913-631-8888",
            "fax_number": "913-962-1627"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6308 MONROVIA ST",
            "city": "SHAWNEE",
            "state": "KS",
            "postal_code": "662161107",
            "telephone_number": "913-631-8888",
            "fax_number": "913-962-1627"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARK BALDERSTON DC PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-10",
        "last_updated": "2010-12-21",
        "status": "A",
        "authorized_official_last_name": "BALDERSTON",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "CHIROPRACTOR",
        "authorized_official_telephone_number": "913-631-8888",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "KS",
            "license": "01-03482",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MARK BALDERSTON DC PA",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Shawnee, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.