Active NPI
Mark Richard Cobleigh, D.C.
- Chiropractor
- Bellevue, NE
National Provider Identifier
1407930878
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 633
- Practice address
- 10403 S 15TH St
Suite 102
Bellevue, NE 68123-4448 - Phone
- (402) 734-6711
- Fax
- (402) 734-4162
- NPI assigned
- Oct 24, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 633 | NE | Primary |
Addresses
Primary practice location
10403 S 15TH St
Suite 102
Bellevue, NE 68123-4448
Mailing address
10403 S 15TH St
Suite 102
Bellevue, NE 68123-4448
Phone (402) 734-6711
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0991463 | Medicaid | IA | |
| 4561145 | Other | NE | MIDLANDS CHOICE |
| 4480052 | Medicaid | NE | |
| 09618 | Other | NE | BLUE CROSS BLUE SHIELD |
| 470613526-13 | Medicaid | NE |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 633 | KS | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mark R. Cobleigh | Chiropractor | Past | Accepting new patients |
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": "1161648000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1315872000000",
"number": "1407930878",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10403 S 15TH ST",
"address_2": "SUITE 102",
"city": "BELLEVUE",
"state": "NE",
"postal_code": "681234448",
"telephone_number": "402-734-6711",
"fax_number": "402-734-4162"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10403 S 15TH ST",
"address_2": "SUITE 102",
"city": "BELLEVUE",
"state": "NE",
"postal_code": "681234448",
"telephone_number": "402-734-6711",
"fax_number": "402-734-4162"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COBLEIGH",
"first_name": "MARK",
"middle_name": "RICHARD",
"name_prefix": "Dr.",
"credential": "D.C.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-10-24",
"last_updated": "2011-09-13",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "NE",
"license": "633",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0991463",
"state": "IA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MIDLANDS CHOICE",
"identifier": "4561145",
"state": "NE"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "4480052",
"state": "NE"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "09618",
"state": "NE"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "470613526-13",
"state": "NE"
}
],
"endpoints": [],
"other_names": []
}Other providers in Bellevue, NE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 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.