Active NPI
Mark A Myers, M.D.
- Orthopaedic Surgery of the Spine Physician
- Shelbyville, KY
National Provider Identifier
1467456855
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthopaedic Surgery of the Spine Physician
- License
- 32619
- Practice address
- 1741 Midland TRL
Shelbyville, KY 40065-1711 - Phone
- (502) 633-0192
- Fax
- (502) 633-4164
- NPI assigned
- Jun 13, 2005
- 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 |
|---|---|---|---|---|
| Orthopaedic Surgery of the Spine Physician | 207XS0117X | 32619 | KY | Primary |
Addresses
Primary practice location
1741 Midland TRL
Shelbyville, KY 40065-1711
Mailing address
18 Village Plaza, PMB 136
Shelbyville, KY 40065-1711
Phone (502) 633-0192
Other identifiers 8
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 122601 | Other | KY | CHA |
| 5134693001 | Other | KY | CIGNA |
| 5344332 | Other | KY | AETNA |
| 64326192 | Medicaid | KY | |
| PASSPORT ADVANTAGE | Other | KY | 2434349000 |
| 000000041773 | Other | KY | ANTHEM |
| 000802487 | Other | KY | HUMANA |
| 1063266 | Other | KY | PASSPORT HEALTH PLAN |
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
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 32619 | KY | MD | Orthopaedic Surgery of the Spine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1118620800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1555632000000",
"number": "1467456855",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "18 VILLAGE PLAZA, PMB 136",
"city": "SHELBYVILLE",
"state": "KY",
"postal_code": "400651711",
"telephone_number": "502-633-0192",
"fax_number": "502-633-4164"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1741 MIDLAND TRL",
"city": "SHELBYVILLE",
"state": "KY",
"postal_code": "400651711",
"telephone_number": "502-633-0192",
"fax_number": "502-633-4164"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MYERS",
"first_name": "MARK",
"middle_name": "A",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-06-13",
"last_updated": "2019-04-19",
"status": "A"
},
"taxonomies": [
{
"code": "207XS0117X",
"taxonomy_group": "",
"desc": "Orthopaedic Surgery, Orthopaedic Surgery of the Spine",
"state": "KY",
"license": "32619",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CHA",
"identifier": "122601",
"state": "KY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA",
"identifier": "5134693001",
"state": "KY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "5344332",
"state": "KY"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "64326192",
"state": "KY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "2434349000",
"identifier": "PASSPORT ADVANTAGE",
"state": "KY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM",
"identifier": "000000041773",
"state": "KY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HUMANA",
"identifier": "000802487",
"state": "KY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PASSPORT HEALTH PLAN",
"identifier": "1063266",
"state": "KY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Shelbyville, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.