Organization Active NPI

Mark Lique, D.C., LLC

  • Chiropractor
  • Haverhill, MA
National Provider Identifier
1639449424
Registry record updated May 1, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2921 Issued in MA
Legal business name
MARK LIQUE, D.C., LLC
Practice address
606 Broadway
Haverhill, MA 01832-1206
Phone
(978) 521-2225
NPI assigned
Jan 10, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 1, 2018

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

Authorized official

Name
Dr. Mark Kevin Lique, D.C.NPI 1659479509
Title
Owner
Phone
(978) 290-0568

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 2921 MA Primary

Addresses

Primary practice location

606 Broadway
Haverhill, MA 01832-1206

Mailing address

606 Broadway
Haverhill, MA 01832-1206
Phone (978) 521-2225

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120131000730 MA Part B Supplier - Clinic/Group Practice 3476710633 Receives reassigned benefits from 1 practitioner
Practice locations: Haverhill, MA

National Provider Directory

National Provider Directory

Locations

606 Broadway
Haverhill, MA 01832
Phone (978) 290-0568

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1326153600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1525132800000",
    "number": "1639449424",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "606 BROADWAY",
            "city": "HAVERHILL",
            "state": "MA",
            "postal_code": "018321206",
            "telephone_number": "978-521-2225",
            "fax_number": "978-521-2678"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "606 BROADWAY",
            "city": "HAVERHILL",
            "state": "MA",
            "postal_code": "018321206",
            "telephone_number": "978-521-2225"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARK LIQUE, D.C., LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-01-10",
        "last_updated": "2018-05-01",
        "status": "A",
        "authorized_official_last_name": "LIQUE",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "KEVIN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "978-290-0568",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "MA",
            "license": "2921",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Haverhill, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.