Mark T Mahoney DO PC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

0102201617 Issued in VA

Legal business name

MARK T MAHONEY DO PC

Practice address

445 Commonwealth Blvd E
Suite a
Martinsville, VA 24112-2086

Phone

(276) 666-0500

Fax

(276) 666-0400

NPI assigned

Mar 19, 2014

Organization subpart

No

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

Authorized official

Name

Dr. Mark Thomas Mahoney, DONPI 1689863615

Title

Owner

Phone

(276) 666-0500

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• MAHONEY FAMILY MEDICINE Other name

Locations

Practitioners 1

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

• Mark T Mahoney, D.O.

  • Family Medicine Physician
  • Martinsville, VA
  • NPI 1689863615

  Family Medicine

  NPD Authorized official

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

{
    "created_epoch": "1395187200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1395187200000",
    "number": "1356768097",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5544",
            "city": "MARTINSVILLE",
            "state": "VA",
            "postal_code": "241155544",
            "telephone_number": "276-666-0500",
            "fax_number": "276-666-0400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "445 COMMONWEALTH BLVD E",
            "address_2": "SUITE A",
            "city": "MARTINSVILLE",
            "state": "VA",
            "postal_code": "241122086",
            "telephone_number": "276-666-0500",
            "fax_number": "276-666-0400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARK T MAHONEY DO PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-03-19",
        "last_updated": "2014-03-19",
        "status": "A",
        "authorized_official_last_name": "MAHONEY",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "THOMAS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "276-666-0500",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "VA",
            "license": "0102201617",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA",
            "identifier": "49D1032709",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MAHONEY FAMILY MEDICINE",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Laura R Mallinak
• Raymond Frank Mallinak, DDS
• Benjamin Lowell Mann, PA
• Peter J Mannen, PA-C
• Mark a. Crabtree DDS, LTD.
• Mark Thomas Mahoney, D.O., P.C.
• Celeisha Martin, FNP-C
• Jennifer L Martin
• Julie G. Martin, P.T.
• Laquinta Martin

• All providers in Martinsville, VA
• Family Medicine Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.