Individual provider Active NPI

Mark Russell Melton, D.C.

  • Chiropractor
  • Hays, KS
National Provider Identifier
1497049803
Registry record updated Jun 5, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
01-05404 Issued in KS
Practice address
2707 Vine St
1
Hays, KS 67601-1949
Phone
(785) 628-2105
Fax
(785) 628-2165
NPI assigned
Jun 2, 2011
Last updated
Jun 5, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 5, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 01-05404 KS Primary

Addresses

Primary practice location

2707 Vine St
1
Hays, KS 67601-1949

Mailing address

2707 Vine St
1
Hays, KS 67601-1949
Phone (785) 628-2105

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110615000597 KS Practitioner - Chiropractic 5991982134 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Cleveland Chiropractic College - Kansas City, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Koerner Chiropractic PAGroup PAC ID 8921137993, 3 clinicians

Practice addresses (Care Compare)

2707 Vine St
Suite 1
Hays, KS 67601-1907
Phone (785) 628-2105

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
01-05404KSMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Koerner Chiropractic PA Chiropractor CurrentSince Jun 7, 2011 Accepting new patients
Koerner Chiropractic PA Chiropractor CurrentSince Jun 7, 2011 Accepting new patients

Locations

105 W 9th St
Ellis, KS 67637
Phone (785) 726-3452

2707 Vine St
Hays, KS 67601

2707 Vine St
Ste 1
Hays, KS 67601
Phone (785) 628-2105

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1306972800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1307232000000",
    "number": "1497049803",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2707 VINE ST",
            "address_2": "1",
            "city": "HAYS",
            "state": "KS",
            "postal_code": "676011949",
            "telephone_number": "785-628-2105",
            "fax_number": "785-628-2165"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2707 VINE ST",
            "address_2": "1",
            "city": "HAYS",
            "state": "KS",
            "postal_code": "676011949",
            "telephone_number": "785-628-2105",
            "fax_number": "785-628-2165"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MELTON",
        "first_name": "MARK",
        "middle_name": "RUSSELL",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-06-02",
        "last_updated": "2011-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "KS",
            "license": "01-05404",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hays, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.