Organization Active NPI

Dr Marcus L Schroeder a Professional Chiropractic Corp

  • Chiropractor
  • Covington, LA
National Provider Identifier
1467658625
Registry record updated Nov 1, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
1260 Issued in LA
Legal business name
DR MARCUS L SCHROEDER A PROFESSIONAL CHIROPRACTIC CORP
Practice address
1982 N Highway 190
Covington, LA 70433-5158
Phone
(985) 871-7411
Fax
(985) 871-9726
NPI assigned
Jun 25, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 1, 2012

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

Authorized official

Name
Dr. Marcus Schroeder, D.C.NPI 1689683450
Title
President
Phone
(985) 871-7411

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
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 1260 LA Primary

Addresses

Primary practice location

1982 N Highway 190
Covington, LA 70433-5158

Mailing address

1982 N Highway 190
Covington, LA 70433-5158
Phone (985) 871-7411

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080305000420 LA Part B Supplier - Clinic/Group Practice 4284719907 Receives reassigned benefits from 3 practitioners
Practice locations: Covington, LA

National Provider Directory

National Provider Directory

Locations

1982 N Highway 190
Covington, LA 70433
Phone (985) 871-7411

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1182729600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1351728000000",
    "number": "1467658625",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1982 N HIGHWAY 190",
            "city": "COVINGTON",
            "state": "LA",
            "postal_code": "704335158",
            "telephone_number": "985-871-7411",
            "fax_number": "985-871-9726"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1982 N HIGHWAY 190",
            "city": "COVINGTON",
            "state": "LA",
            "postal_code": "704335158",
            "telephone_number": "985-871-7411",
            "fax_number": "985-871-9726"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR MARCUS L SCHROEDER A PROFESSIONAL CHIROPRACTIC CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-25",
        "last_updated": "2012-11-01",
        "status": "A",
        "authorized_official_last_name": "SCHROEDER",
        "authorized_official_first_name": "MARCUS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "985-871-7411",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "LA",
            "license": "1260",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Covington, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2012; 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.