Mark Vincent, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

95-01448 Issued in NC

Practice address

19485 Old Jetton Rd
Suite 100
Cornelius, NC 28031-6582

Phone

(704) 384-1775

NPI assigned

May 8, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Family Practice

Education

Other, 1992

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Marque Medical Clinic, Inc.Group PAC ID 9537345665, 21 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir-myrecord.cerner.com/r4/c32cb33f-ec61-4f25-9140-0b9b174fe4db/

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.

• Marque Medical Clinic, Inc.

  • Urgent Care Clinic/Center
  • Newport Beach, CA
  • NPI 1538466107

  Family Medicine

  Medicare reassignment Care Compare group NPD
• Marque Medical Clinic, Inc

  • Urgent Care Clinic/Center
  • Chula Vista, CA
  • NPI 1164303442
  NPD
• Cabarrus Family Medicine

  • Primary Care Clinic/Center
  • Concord, NC
  • NPI 1679758759
  NPD (past)
• Cabarrus Family Medicine

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Concord, NC
  • NPI 1750566832
  NPD (past)

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

{
    "created_epoch": "1178582400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1554681600000",
    "number": "1336352012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 602362",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282602362",
            "telephone_number": "704-316-4979",
            "fax_number": "704-316-4978"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19485 OLD JETTON RD",
            "address_2": "SUITE 100",
            "city": "CORNELIUS",
            "state": "NC",
            "postal_code": "280316582",
            "telephone_number": "704-384-1775"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "123 Professional Park Dr Ste 200",
            "address_purpose": "LOCATION",
            "city": "Mooresville",
            "state": "NC",
            "postal_code": "281175519",
            "country_code": "US",
            "telephone_number": "423-343-7016",
            "fax_number": "423-343-7017",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VINCENT",
        "first_name": "MARK",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-08",
        "last_updated": "2019-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "SC",
            "license": "39542",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "95-01448",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8985059",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Vezendy Chiropractic, PC
• Jon Michael Vezendy, DC
• Vibe Therapy LKN, PLLC
• Village Counseling, PLLC
• Jesus Raymundo Villanueva
• Jamie Tanner Vlasic, DNP, WHNP-BC, MSCP
• Moira Vowells
• Erin Able Wagner, MPA-C
• Pamela Lou Wagner, LPC
• Walgreen Co

• Family Medicine Physician in Cornelius, NC
• Providers in Cornelius, NC by specialty
• Family Medicine Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.