Individual provider Active NPI

Mark Fedorczyk, D.C.

  • Chiropractor
  • Frederick, MD
National Provider Identifier
1447433685
Registry record updated Dec 11, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
SO1649 Issued in MD
Practice address
1050 Key Pkwy
Suite 202
Frederick, MD 21702-4056
Phone
(301) 846-2273
Fax
(301) 620-2273
NPI assigned
Dec 11, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 11, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X SO1649 MD Primary

Addresses

Primary practice location

1050 Key Pkwy
Suite 202
Frederick, MD 21702-4056

Mailing address

1005 Cheryls CT
Frederick, MD 21703-8400
Phone (240) 357-0342

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
SO1649MDMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Frederick Health Hospital Inc Past Accepting new patients
Universal Healthcare Specialists, LLC PastSince Oct 3, 2011 Accepting new patients

Organizations & group practices 2

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": "1197331200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1197331200000",
    "number": "1447433685",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1005 CHERYLS CT",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217038400",
            "telephone_number": "240-357-0342",
            "fax_number": "301-696-0114"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1050 KEY PKWY",
            "address_2": "SUITE 202",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217024056",
            "telephone_number": "301-846-2273",
            "fax_number": "301-620-2273"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FEDORCZYK",
        "first_name": "MARK",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-12-11",
        "last_updated": "2007-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MD",
            "license": "SO1649",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Frederick, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2007; 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.