NPIMap

Organization Active NPI

Mt Vernon Spine & Rehab

  • Chiropractor
  • Baltimore, MD
National Provider Identifier
1578074415
Registry record updated Oct 18, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
S01983 Issued in MD
Legal business name
MT VERNON SPINE & REHAB
Practice address
836 Guilford Ave
Baltimore, MD 21202-3707
Phone
(410) 244-0440
Fax
(410) 837-8665
NPI assigned
Oct 18, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 18, 2017

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

Authorized official

Name
Dr. Reginald Marcus Allen, DC
Title
President/Doctor
Phone
(410) 244-0440

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X S01983 MD Primary

Addresses

Primary practice location

836 Guilford Ave
Baltimore, MD 21202-3707

Mailing address

836 Guilford Ave
Baltimore, MD 21202-3707
Phone (410) 244-0440

National Provider Directory

National Provider Directory

Locations

836 Guilford Ave
Baltimore, MD 21202
Phone (410) 244-0440

NPI Registry JSON

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

{
    "created_epoch": "1508284800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1508284800000",
    "number": "1578074415",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "836 GUILFORD AVE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212023707",
            "telephone_number": "410-244-0440",
            "fax_number": "410-837-8665"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "836 GUILFORD AVE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212023707",
            "telephone_number": "410-244-0440",
            "fax_number": "410-837-8665"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MT VERNON SPINE & REHAB",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-10-18",
        "last_updated": "2017-10-18",
        "status": "A",
        "authorized_official_last_name": "ALLEN",
        "authorized_official_first_name": "REGINALD",
        "authorized_official_middle_name": "MARCUS",
        "authorized_official_title_or_position": "PRESIDENT/DOCTOR",
        "authorized_official_telephone_number": "410-244-0440",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "MD",
            "license": "S01983",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2017; 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.