Individual provider Active NPI

Mark Allen Lindholm, D.C.

  • Chiropractor
  • Elkhart, IN
National Provider Identifier
1528145349
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
08001457A Issued in IN
Practice address
601 E Bristol St
Elkhart, IN 46514-3418
Phone
(574) 262-4402
Fax
(574) 264-0778
NPI assigned
Nov 1, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 08001457A IN Primary

Addresses

Primary practice location

601 E Bristol St
Elkhart, IN 46514-3418

Mailing address

601 E Bristol St
Elkhart, IN 46514-3418
Phone (574) 262-4402

Other identifiers 1

IdentifierTypeStateIssuer
000000269183OtherINBCBS

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110624000012 IN Practitioner - Chiropractic 1951589878 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - West Sunnyvale, 1993
Medicare assignment
May accept Medicare assignment
Group practices
Lindholm Chiropractic PCGroup PAC ID 0042498966, 4 clinicians

Practice addresses (Care Compare)

625 E Bristol St
Elkhart, IN 46514-3476

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

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": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1528145349",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 E BRISTOL ST",
            "city": "ELKHART",
            "state": "IN",
            "postal_code": "465143418",
            "telephone_number": "574-262-4402",
            "fax_number": "574-264-0778"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 E BRISTOL ST",
            "city": "ELKHART",
            "state": "IN",
            "postal_code": "465143418",
            "telephone_number": "574-262-4402",
            "fax_number": "574-264-0778"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LINDHOLM",
        "first_name": "MARK",
        "middle_name": "ALLEN",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IN",
            "license": "08001457A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "000000269183",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Elkhart, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.