Active NPI
Mark Alan Sloane, D.O.
- Developmental - Behavioral Pediatrics Physician
- Portage, MI
National Provider Identifier
1568558229
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Developmental - Behavioral Pediatrics Physician
- License
- 5101008273
- Practice address
- 700 Mall Dr
Suite C
Portage, MI 49024-1800 - Phone
- (269) 373-1170
- Fax
- (269) 373-1154
- NPI assigned
- Oct 4, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Developmental - Behavioral Pediatrics Physician | 2080P0006X | 5101008273 | MI | Primary |
Addresses
Primary practice location
700 Mall Dr
Suite C
Portage, MI 49024-1800
Mailing address
7604 Dunross Drive
Portage, MI 49024
Phone (269) 327-6072
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5101008273 | MI | MD | Developmental - Behavioral Pediatrics Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159920000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1204070400000",
"number": "1568558229",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7604 DUNROSS DRIVE",
"city": "PORTAGE",
"state": "MI",
"postal_code": "49024",
"telephone_number": "269-327-6072"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "700 MALL DR",
"address_2": "SUITE C",
"city": "PORTAGE",
"state": "MI",
"postal_code": "490241800",
"telephone_number": "269-373-1170",
"fax_number": "269-373-1154"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SLOANE",
"first_name": "MARK",
"middle_name": "ALAN",
"name_prefix": "Dr.",
"credential": "D.O.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-10-04",
"last_updated": "2008-02-27",
"status": "A"
},
"taxonomies": [
{
"code": "2080P0006X",
"taxonomy_group": "",
"desc": "Pediatrics, Developmental - Behavioral Pediatrics",
"state": "MI",
"license": "5101008273",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Portage, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.