Organization Active NPI

Chiropractic Clinic, LLC

Doing business as Dr Mark Holliman

  • Chiropractor
  • Memphis, TN
National Provider Identifier
1407134869
Registry record updated Aug 3, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC0000001293 Issued in TN
Legal business name
CHIROPRACTIC CLINIC, LLC
Doing business as
Dr Mark Holliman
Practice address
6520 Quince Rd
Memphis, TN 38119-8211
Phone
(901) 821-9312
Fax
(901) 821-9317
NPI assigned
Aug 2, 2011
Last updated
Aug 3, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 3, 2011

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

Authorized official

Name
Dr. Mark Holliman, DCNPI 1467561324
Title
Chiropractic Physician
Phone
(901) 821-9312

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X DC0000001293 TN Primary

Addresses

Primary practice location

6520 Quince Rd
Memphis, TN 38119-8211

Mailing address

PO Box 382987
Germantown, TN 38183-2987
Phone (901) 821-9312

Other names 1

  • Dr Mark Holliman Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110804000003 TN Part B Supplier - Clinic/Group Practice 5092984286 Receives reassigned benefits from 1 practitioner
Practice locations: Memphis, TN

National Provider Directory

National Provider Directory

Locations

6520 Quince Rd
Memphis, TN 38119
Phone (901) 821-9312

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1312243200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1312329600000",
    "number": "1407134869",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 382987",
            "city": "GERMANTOWN",
            "state": "TN",
            "postal_code": "381832987",
            "telephone_number": "901-821-9312",
            "fax_number": "901-821-9317"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6520 QUINCE RD",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381198211",
            "telephone_number": "901-821-9312",
            "fax_number": "901-821-9317"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHIROPRACTIC CLINIC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-08-02",
        "last_updated": "2011-08-03",
        "status": "A",
        "authorized_official_last_name": "HOLLIMAN",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "CHIROPRACTIC PHYSICIAN",
        "authorized_official_telephone_number": "901-821-9312",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "TN",
            "license": "DC0000001293",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dr Mark Holliman",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Memphis, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.