Individual provider Active NPI

Mark Kenneth McPherson, M.D.

  • Family Medicine Physician
  • Fort Rucker, AL
National Provider Identifier
1649228560
Registry record updated Aug 31, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
043091 Issued in GA
Practice address
5700 Novosell
Usaama Rm220
Fort Rucker, AL 36330-5901
Phone
(334) 255-0750
NPI assigned
May 4, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 31, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 043091 GA Primary
Aerospace Medicine Physician 2083A0100X 043091 GA

Addresses

Primary practice location

5700 Novosell
Usaama Rm220
Fort Rucker, AL 36330-5901

Mailing address

203 E Morningview Dr
Enterprise, AL 36330-4166
Phone (703) 725-8998

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 Medicine

State licenses

LicenseStateTypeSpecialty
043091GAMDAerospace Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1146700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1314748800000",
    "number": "1649228560",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "203 E MORNINGVIEW DR",
            "city": "ENTERPRISE",
            "state": "AL",
            "postal_code": "363304166",
            "telephone_number": "703-725-8998"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5700 NOVOSELL",
            "address_2": "USAAMA RM220",
            "city": "FORT RUCKER",
            "state": "AL",
            "postal_code": "363305901",
            "telephone_number": "334-255-0750"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCPHERSON",
        "first_name": "MARK",
        "middle_name": "KENNETH",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-04",
        "last_updated": "2011-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "043091",
            "primary": true
        },
        {
            "code": "2083A0100X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Aerospace Medicine",
            "state": "GA",
            "license": "043091",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Rucker, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2011; 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.