Mark Anthony Anderson, DC – Chiropractor

Key facts

NPI: 1487740924
Entity type: Individual (NPI type 1)
Primary specialty: Chiropractor 111N00000X
License: 5445 (CO)
Practice address: 2480 Youngfield St
Lakewood, CO 80215
Phone: (303) 237-7900
Fax: (303) 237-7638
NPI assigned: Oct 4, 2006
Sex: Male
Sole proprietor: No

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.

Anderson Family Chiropractic, LLC Chiropractor · Lakewood, CO · NPI 1649614918

NPD (past) Authorized official CHIROPRACTOR
Clearly Chiropractic Professional LLC Chiropractor · Lakewood, CO · NPI 1578754834

NPD (past) Authorized official CHIROPRACTOR

Medicare participation

Medicare fee-for-service enrollment: Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD): Yes

State licenses

License	State	Type	Specialty
5445	CO	MD	Chiropractor

Practice roles

Organization	Specialty	Status	New patients
Anderson Family Chiropractic, LLC	Chiropractor	Past	Accepting new patients
Clearly Chiropractic Professional LLC	Chiropractor	Past since Jan 1, 2009	Accepting new patients

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Chiropractor	111N00000X	5445	CO	Yes

Addresses

Primary practice location

2480 Youngfield St
Lakewood, CO 80215

Mailing address

2480 Youngfield Street
Lakewood, CO 80215
Phone (303) 237-7900

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jul 8, 2007.

{
    "created_epoch": "1159920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1487740924",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2480 YOUNGFIELD STREET",
            "city": "LAKEWOOD",
            "state": "CO",
            "postal_code": "80215",
            "telephone_number": "303-237-7900",
            "fax_number": "303-237-7638"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2480 YOUNGFIELD ST",
            "city": "LAKEWOOD",
            "state": "CO",
            "postal_code": "80215",
            "telephone_number": "303-237-7900",
            "fax_number": "303-237-7638"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "MARK",
        "middle_name": "ANTHONY",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-04",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CO",
            "license": "5445",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakewood, CO

All providers in Lakewood, CO · Chiropractor in Colorado

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.