Active NPI
Mark Gerard Wurth, D.C.
- Chiropractor
- Omaha, NE
National Provider Identifier
1225057698
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 817
- Practice address
- 10888 W Dodge Rd
Omaha, NE 68154-2609 - Phone
- (402) 551-1322
- Fax
- (402) 551-3454
- NPI assigned
- Jul 18, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 817 | NE | Primary |
Addresses
Primary practice location
10888 W Dodge Rd
Omaha, NE 68154-2609
Mailing address
10888 W Dodge Rd
Omaha, NE 68154-2609
Phone (402) 551-1322
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 47077739600 | Medicaid | NE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NE
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20041130000844 | NE | Practitioner - Chiropractic | 6204891344 | Practice locations: Omaha, NE |
Care Compare profile
Medicare Care Compare- Specialty
- Chiropractic
- Education
- Northwestern College of Chiropractic, 1983
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
10888 W Dodge Rd
Omaha, NE 68154-2609
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 817 | NE | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153180800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1645747200000",
"number": "1225057698",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10888 W DODGE RD",
"city": "OMAHA",
"state": "NE",
"postal_code": "681542609",
"telephone_number": "402-551-1322",
"fax_number": "402-551-3454"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10888 W DODGE RD",
"city": "OMAHA",
"state": "NE",
"postal_code": "681542609",
"telephone_number": "402-551-1322",
"fax_number": "402-551-3454"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WURTH",
"first_name": "MARK",
"middle_name": "GERARD",
"credential": "D.C.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-07-18",
"last_updated": "2022-02-25",
"certification_date": "2022-02-25",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "NE",
"license": "817",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "47077739600",
"state": "NE"
}
],
"endpoints": [],
"other_names": []
}Other providers in Omaha, NE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2022; 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.