Mark Joseph Hancock, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

67750 Issued in GA

Practice address

135 Maple St
BLDG a
Decatur, GA 30030-3953

Phone

(706) 297-1510

Fax

(470) 575-2575

NPI assigned

Apr 10, 2008

Last updated

Jul 6, 2022By the provider in NPPES

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Jan 1, 2020 through Jan 1, 2028

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Candler Medical Group, Inc. - Metter

  • Family Medicine Physician
  • Metter, GA
  • NPI 1023039732
  NPD

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

{
    "created_epoch": "1207785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657065600000",
    "number": "1407029382",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "135 MAPLE ST",
            "address_2": "BLDG A",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300303953",
            "telephone_number": "706-297-1510",
            "fax_number": "470-575-2575"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "135 MAPLE ST",
            "address_2": "BLDG A",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300303953",
            "telephone_number": "706-297-1510",
            "fax_number": "470-575-2575"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HANCOCK",
        "first_name": "MARK",
        "middle_name": "JOSEPH",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-04-10",
        "last_updated": "2022-07-06",
        "certification_date": "2022-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "67750",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Glenn Randall Hamilton, RPH
• Vanessa Hamlet, LPC
• Bailey Ireland Hammond
• Camron Hampshire, LCSW
• Michaela Rochelle Hampton, RN
• John Carter Handy, RPH
• Tiffany Shea Haney, M.S.
• Minh Tuan Hang, M.D.
• Thuy-Van Pham Hang, M.D.
• Hanger Prosthetics & Orthotics East Inc (Hanger Clinic)

• Family Medicine Physician in Decatur, GA
• Providers in Decatur, GA by specialty
• Family Medicine Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.