Organization Active NPI

Mark J Demalio DC Inc

  • Chiropractor
  • Niles, OH
National Provider Identifier
1275716813
Registry record updated Sep 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
1902 Issued in OH
Legal business name
MARK J DEMALIO DC INC
Practice address
1250 Youngstown Warren Rd
Suite B
Niles, OH 44446
Phone
(330) 652-5600
NPI assigned
Dec 5, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 6, 2022

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

Authorized official

Name
Dr. Mark Joseph Demalio, DCNPI 1376513424
Title
President
Phone
(330) 652-5600

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 1902 OH Primary

Addresses

Primary practice location

1250 Youngstown Warren Rd
Suite B
Niles, OH 44446

Mailing address

1250 Youngstown Warren Rd
Suite B
Niles, OH 44446-4649
Phone (330) 652-5600

Other identifiers 3

IdentifierTypeStateIssuer
000000139904OtherOHANTHEM BCBS
0911204MedicaidOH
2303009OtherOHAETNA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20071219000338 OH Part B Supplier - Clinic/Group Practice 0446340079 Receives reassigned benefits from 1 practitioner
Practice locations: Niles, OH

National Provider Directory

National Provider Directory

Locations

1552 North Rd SE
Ste 202
Warren, OH 44484
Phone (330) 856-5799

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1196812800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1662422400000",
    "number": "1275716813",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1250 YOUNGSTOWN WARREN RD",
            "address_2": "SUITE B",
            "city": "NILES",
            "state": "OH",
            "postal_code": "444464649",
            "telephone_number": "330-652-5600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1250 YOUNGSTOWN WARREN RD",
            "address_2": "SUITE B",
            "city": "NILES",
            "state": "OH",
            "postal_code": "44446",
            "telephone_number": "330-652-5600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARK J DEMALIO DC INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-05",
        "last_updated": "2022-09-06",
        "certification_date": "2022-09-06",
        "status": "A",
        "authorized_official_last_name": "DEMALIO",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "JOSEPH",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "330-652-5600",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "OH",
            "license": "1902",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS",
            "identifier": "000000139904",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0911204",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "2303009",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Niles, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.