Mark Irwin, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

336-023425 Issued in IL

Practice address

2900 Frank Scott Pkwy W
Suite 904
Belleville, IL 62223-5000

Phone

(618) 234-0640

Fax

(314) 851-4475

NPI assigned

Nov 4, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 10

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: mark.irwin.p1@direct.essehealth.nextgenshare.com

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.

• Chiromed LTD

  • Chiropractor
  • Belleville, IL
  • NPI 1962403907
  NPD (past)
• Washington University

  • Multi-Specialty Clinic/Center
  • Saint Louis, MO
  • NPI 1194765685
  NPD (past)

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

{
    "created_epoch": "1131062400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1348185600000",
    "number": "1366433567",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 23340",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631563340",
            "telephone_number": "618-234-0640",
            "fax_number": "314-851-4475"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2900 FRANK SCOTT PKWY W",
            "address_2": "SUITE 904",
            "city": "BELLEVILLE",
            "state": "IL",
            "postal_code": "622235000",
            "telephone_number": "618-234-0640",
            "fax_number": "314-851-4475"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IRWIN",
        "first_name": "MARK",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-04",
        "last_updated": "2012-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "336-023425",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036058840",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ESSENCE",
            "identifier": "000000010019",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHLINK",
            "identifier": "113626",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS IL",
            "identifier": "8221955",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHP",
            "identifier": "127443",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS TRI ST",
            "identifier": "129537",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "129537",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UHC",
            "identifier": "0450347",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "5561291",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MERCY",
            "identifier": "D14440",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Inspire Community Homes
• Inspire Community Homes LLC
• Integrated Pain Specialists, LTD
• Corin L Intrieri, O.T.
• Mohamed Iqbal, MD
• Nicole M Isenhart
• IV Care, LLC
• Cynthia Therese Izzo, MSW
• Joseph Ray Jackson, M.A.
• Kierra Jackson

• Internal Medicine Physician in Belleville, IL
• Providers in Belleville, IL by specialty
• Internal Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2012; 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.