Mark A Addante, D.C., CCSP

Individual provider Active NPI Sports Physician Chiropractor · Salida, CO

NPI 1245255017 · NPPES record last updated May 2, 2016

Key facts

NPI
1245255017
Entity type
Individual (NPI type 1)
Primary specialty
Sports Physician Chiropractor 111NS0005X
License
5493 (CO)
Practice address
504 Oak St
Unit 2
Salida, CO 81201-3252
Phone
(719) 539-9493
Fax
(719) 539-9496
NPI assigned
Jul 13, 2006
Sex
Male
Sole proprietor
No

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.

Medicare Care Compare profile

Specialty
Chiropractic
Education
Logan College of Chiropractic, 2000
Medicare assignment
May accept Medicare assignment
Group practices
Addante Chiropractic, PC (2 clinicians)

Practice addresses (Care Compare)

504 Oak St
Unit 2
Salida, CO 81201-3261
Phone (719) 539-9493

Medicare participation

Medicare fee-for-service enrollment
Enrolled in CO

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20111116000712 CO Practitioner - Chiropractic 9537067814 Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
5493COMDSports Physician Chiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Addante Chiropractic, PC Sports Physician Current
since Jul 21, 2003
Accepting new patients

Locations

504 Oak St
Unit 2
Salida, CO 81201
Phone (719) 539-9493

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Physician Chiropractor 111NS0005X 5493 CO Yes

Addresses

Primary practice location

504 Oak St
Unit 2
Salida, CO 81201-3252

Mailing address

504 Oak St
Unit 2
Salida, CO 81201-3252
Phone (719) 539-9493

Other providers in Salida, CO

All providers in Salida, CO · Sports Physician Chiropractor in Colorado

Sources for this page

Verify at the official NPI Registry.