Individual provider Active NPI

Mark Allan Hinton, M.D.

  • Child & Adolescent Psychiatry Physician
  • Lackland a F B, TX
National Provider Identifier
1396717781
Registry record updated Dec 31, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X
License
K1216 Issued in TX
Practice address
2200 Bergquist Dr
Ste 1
Lackland a F B, TX 78236-9907
Phone
(228) 257-1978
Fax
(210) 292-2520
NPI assigned
Feb 2, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 31, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X K1216 TX
Child & Adolescent Psychiatry Physician 2084P0804X K1216 TX Primary

Addresses

Primary practice location

2200 Bergquist Dr
Ste 1
Lackland a F B, TX 78236-9907

Mailing address

2200 Bergquist Dr
Ste 1
Lackland a F B, TX 78236-9907
Phone (228) 257-1978

Other identifiers 2

IdentifierTypeStateIssuer
1396717781MedicaidTX
1396717781OtherTXTRICARE

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20160212000175 TX Practitioner - Psychiatry 2163726076 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Hill Country Community MHMR Center CurrentSince Jul 1, 2017 Accepting new patients
University of Texas Southwestern Medical Center at Dallas Psychiatry CurrentSince Dec 5, 2015 Accepting new patients
The University of Texas Southwestern Medical Center at Dallas CurrentSince Dec 5, 2015 Accepting new patients
St. Luke'S Physician Group, Inc. Current Accepting new patients
Heart of Texas Region MHMR Center CurrentSince Apr 20, 2020 Accepting new patients
University of Texas Southwestern Medical Center at Dallas Current Accepting new patients
St Luke'S Physician Group Inc CurrentSince Aug 4, 2021 Accepting new patients
St Luke'S Physician Group Inc Psychiatry CurrentSince Aug 4, 2021 Accepting new patients

Locations

257 Brodhead Rd
Bethlehem, PA 18017
Phone (484) 503-3057

801 Ostrum St
Fountain Hill, PA 18015
Phone (610) 954-2200

5201 Harry Hines Blvd
Dallas, TX 75235
Phone (214) 590-1396

819 Water St
Ste 300
Kerrville, TX 78028
Phone (830) 258-5430

110 S 12th St
Waco, TX 76701
Phone (254) 297-7124

Interoperability endpoints

  • Direct secure messaging: mark.hinton@slpg.direct-sluhn.org

Organizations & group practices 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1138838400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1388448000000",
    "number": "1396717781",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2200 BERGQUIST DR",
            "address_2": "STE 1",
            "city": "LACKLAND A F B",
            "state": "TX",
            "postal_code": "782369907",
            "telephone_number": "228-257-1978",
            "fax_number": "210-292-2520"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2200 BERGQUIST DR",
            "address_2": "STE 1",
            "city": "LACKLAND A F B",
            "state": "TX",
            "postal_code": "782369907",
            "telephone_number": "228-257-1978",
            "fax_number": "210-292-2520"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HINTON",
        "first_name": "MARK",
        "middle_name": "ALLAN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-02",
        "last_updated": "2013-12-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "TX",
            "license": "K1216",
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "TX",
            "license": "K1216",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1396717781",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "1396717781",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lackland a F B, TX

Sources for this page

Verify at the official NPI Registry.