Back Mountain Neurodiagnostics, PC

Primary specialty

Neurology ChiropractorTaxonomy code 111NN0400X

License

DC007819L Issued in PA

Legal business name

BACK MOUNTAIN NEURODIAGNOSTICS, PC

Practice address

165 S Memorial Hwy
Trucksville, PA 18708-1418

Phone

(570) 696-4348

NPI assigned

Apr 20, 2007

Last updated

Oct 4, 2007By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mark Evan MorrisNPI 1417911637

Title

President

Phone

(570) 696-4348

Specialties & licenses 2

Addresses

Other identifiers 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Mark Evan Morris, D.C.

  • Chiropractor
  • Trucksville, PA
  • NPI 1417911637
  Authorized official Same address or phone

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

{
    "created_epoch": "1177027200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1191456000000",
    "number": "1548487218",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "165 S MEMORIAL HWY",
            "city": "TRUCKSVILLE",
            "state": "PA",
            "postal_code": "187081418",
            "telephone_number": "570-696-4348"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "165 S MEMORIAL HWY",
            "city": "TRUCKSVILLE",
            "state": "PA",
            "postal_code": "187081418",
            "telephone_number": "570-696-4348"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BACK MOUNTAIN NEURODIAGNOSTICS, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-20",
        "last_updated": "2007-10-04",
        "status": "A",
        "authorized_official_last_name": "MORRIS",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "EVAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "570-696-4348"
    },
    "taxonomies": [
        {
            "code": "111NN0400X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Neurology",
            "state": "PA",
            "license": "DC009260",
            "primary": false
        },
        {
            "code": "111NN0400X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Neurology",
            "state": "PA",
            "license": "DC007819L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUPBCBS",
            "identifier": "BA1689016",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kati Autolitano
• Back Mountain Dental, Inc.
• Chiropractic and Rehab Associates of Dallas, PC
• James Clemens Definnis, DMD
• Brandon Michael Jayne, MSPT
• Angela Lynn
• Mark Evan Morris, D.C.

• Neurology Chiropractor in Trucksville, PA
• Providers in Trucksville, PA by specialty
• Neurology Chiropractor in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2007; 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.