Individual provider Active NPI

Mark Gerard Guarino, DC

  • Chiropractor
  • Glen Allen, VA
National Provider Identifier
1396726188
Registry record updated Nov 17, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
0104000710 Issued in VA
Practice address
10148 W Broad St
Ste 101
Glen Allen, VA 23060-6760
Phone
(804) 747-7474
Fax
(804) 965-9360
NPI assigned
Nov 8, 2005
Last updated
Nov 17, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 0104000710 VA Primary

Addresses

Primary practice location

10148 W Broad St
Ste 101
Glen Allen, VA 23060-6760

Mailing address

10148 W Broad St
Ste 101
Glen Allen, VA 23060-6760
Phone (804) 747-7474

Other identifiers 7

IdentifierTypeStateIssuer
170425OtherSOUTHERN HEALTH
460541OtherACN
0827590OtherCIGNA
2125679OtherAETNA
4400136OtherUNITED HEALTH CARE
054234OtherANTHEM
1456026OtherBLUE CROSS HIGH MARK

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0104000710VAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Dr. Will McGhee PLLC Chiropractor CurrentSince Sep 18, 2000 Accepting new patients

Locations

10148 W Broad St
Ste 101
Glen Allen, VA 23060
Phone (804) 747-7424

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1131408000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1321488000000",
    "number": "1396726188",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10148 W BROAD ST",
            "address_2": "STE 101",
            "city": "GLEN ALLEN",
            "state": "VA",
            "postal_code": "230606760",
            "telephone_number": "804-747-7474",
            "fax_number": "804-965-9360"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10148 W BROAD ST",
            "address_2": "STE 101",
            "city": "GLEN ALLEN",
            "state": "VA",
            "postal_code": "230606760",
            "telephone_number": "804-747-7474",
            "fax_number": "804-965-9360"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUARINO",
        "first_name": "MARK",
        "middle_name": "GERARD",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-08",
        "last_updated": "2011-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "VA",
            "license": "0104000710",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SOUTHERN HEALTH",
            "identifier": "170425",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ACN",
            "identifier": "460541",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "0827590",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "2125679",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTH CARE",
            "identifier": "4400136",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "054234",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS HIGH MARK",
            "identifier": "1456026",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Glen Allen, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2011; 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.