Individual provider Active NPI

Mark Andrew Herrmann, DC

  • Chiropractor
  • Lawrence, KS
National Provider Identifier
1467551978
Registry record updated Jul 24, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
01-04252 Issued in KS
Practice address
3320 Clinton Parkway CT Ste 200
Lawrence, KS 66047-2650
Phone
(785) 843-1188
Fax
(785) 843-1166
NPI assigned
Sep 21, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 01-04252 KS Primary

Addresses

Primary practice location

3320 Clinton Parkway CT Ste 200
Lawrence, KS 66047-2650

Mailing address

3320 Clinton Parkway CT Ste 200
Lawrence, KS 66047-2650
Phone (785) 843-1188

Other identifiers 6

IdentifierTypeStateIssuer
01-04252OtherKSSTATE OF KANSAS
CM00101580OtherKSNATIONAL CHIROPRACTIC MUT
017534OtherKSMEDICARE GROUP PTAN
062196OtherKSMEDICARE PTAN
CE006571OtherMOSTATE OF MISSOURI
2855OtherOHSTATE OF OHIO

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
01-04252KSMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Chiropractic Health Center Chiropractor PastSince Apr 3, 2012 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1158796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1248393600000",
    "number": "1467551978",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3320 CLINTON PARKWAY CT STE 200",
            "city": "LAWRENCE",
            "state": "KS",
            "postal_code": "660472650",
            "telephone_number": "785-843-1188",
            "fax_number": "785-843-1166"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3320 CLINTON PARKWAY CT STE 200",
            "city": "LAWRENCE",
            "state": "KS",
            "postal_code": "660472650",
            "telephone_number": "785-843-1188",
            "fax_number": "785-843-1166"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERRMANN",
        "first_name": "MARK",
        "middle_name": "ANDREW",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-21",
        "last_updated": "2009-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "KS",
            "license": "01-04252",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE OF KANSAS",
            "identifier": "01-04252",
            "state": "KS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NATIONAL CHIROPRACTIC MUT",
            "identifier": "CM00101580",
            "state": "KS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP PTAN",
            "identifier": "017534",
            "state": "KS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "062196",
            "state": "KS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE OF MISSOURI",
            "identifier": "CE006571",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE OF OHIO",
            "identifier": "2855",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lawrence, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2009; 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.