Individual provider Active NPI

Mark D Fuerst, D.C.

  • Chiropractor
  • Van Wert, OH
National Provider Identifier
1336418482
Registry record updated May 11, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
4226 Issued in OH
Practice address
10963 Van Wert Decatur Rd
Van Wert, OH 45891-9211
Phone
(419) 238-6686
Fax
(419) 238-6201
NPI assigned
Dec 19, 2011
Last updated
May 11, 2017By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 11, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 4226 OH Primary

Addresses

Primary practice location

10963 Van Wert Decatur Rd
Van Wert, OH 45891-9211

Mailing address

10963 Van Wert Decatur Rd
Van Wert, OH 45891-9211
Phone (419) 238-6686

Other identifiers 2

IdentifierTypeStateIssuer
H536770OtherOHGROUP PTAN
0064320MedicaidOH

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20121117000013 OH Practitioner - Chiropractic 9335390558 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
National College of Chiropractic, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Fuerst Family Chiropractic, LLCGroup PAC ID 4385036037, 3 clinicians

Practice addresses (Care Compare)

10963 Van Wert Decatur Rd
Van Wert, OH 45891-9211
Phone 4192386686110

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4226OHMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Fuerst Family Chiropractic, LLC Chiropractor CurrentSince Dec 3, 2021 Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients
Northwest Lifeforce Corporation Chiropractor PastSince Jun 16, 2011 Accepting new patients

Locations

10963 Van Wert Decatur Rd
Van Wert, OH 45891
Phone (419) 238-6686

Organizations & group practices 3

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1324252800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1494460800000",
    "number": "1336418482",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10963 VAN WERT DECATUR RD",
            "city": "VAN WERT",
            "state": "OH",
            "postal_code": "458919211",
            "telephone_number": "419-238-6686",
            "fax_number": "419-238-6201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10963 VAN WERT DECATUR RD",
            "city": "VAN WERT",
            "state": "OH",
            "postal_code": "458919211",
            "telephone_number": "419-238-6686",
            "fax_number": "419-238-6201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FUERST",
        "first_name": "MARK",
        "middle_name": "D",
        "name_prefix": "Mr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-12-19",
        "last_updated": "2017-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "OH",
            "license": "4226",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP PTAN",
            "identifier": "H536770",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0064320",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Van Wert, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2017; 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.