Individual provider Active NPI

Mark Hall Hoffmann, DC

  • Chiropractor
  • Traverse City, MI
National Provider Identifier
1205953395
Registry record updated Apr 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2301005659 Issued in MI
Practice address
115 E 14TH St
Traverse City, MI 49684-3220
Phone
(231) 943-1767
Fax
(231) 943-1769
NPI assigned
Mar 23, 2007
Last updated
Apr 26, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 26, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 2301005659 MI Primary

Addresses

Primary practice location

115 E 14TH St
Traverse City, MI 49684-3220

Mailing address

PO Box 356
Suttons Bay, MI 49682
Phone (231) 271-3544

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100618000033 MI Practitioner - Chiropractic 0840320826 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Life Chiropractic College, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
14TH Street Chiropractic PLLCGroup PAC ID 4789995499, 4 clinicians

Practice addresses (Care Compare)

115 E 14TH St
14TH Street Chiropractic
Traverse City, MI 49684-3220
Phone (231) 943-1767

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
14TH Street Chiropractic, PLLC Chiropractor CurrentSince Apr 30, 2015 Accepting new patients
Gaston Family Chiropractic LLC Chiropractor PastSince Apr 1, 2023 Accepting new patients

Locations

115 E Fourteenth St
Traverse City, MI 49684
Phone (231) 943-1767

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1174608000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682467200000",
    "number": "1205953395",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 356",
            "city": "SUTTONS BAY",
            "state": "MI",
            "postal_code": "49682",
            "telephone_number": "231-271-3544",
            "fax_number": "231-271-4576"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 E 14TH ST",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496843220",
            "telephone_number": "231-943-1767",
            "fax_number": "231-943-1769"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOFFMANN",
        "first_name": "MARK",
        "middle_name": "HALL",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-23",
        "last_updated": "2023-04-26",
        "certification_date": "2023-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MI",
            "license": "2301005659",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Traverse City, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2023; 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.