Individual provider Active NPI

Mark Alan Schneider, DC

  • Chiropractor
  • Elkhart, IN
National Provider Identifier
1659304525
Registry record updated Mar 29, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
08001048 Issued in IN
Practice address
1178 Fremont CT
Elkhart, IN 46516-9321
Phone
(574) 293-7000
Fax
(574) 293-7004
NPI assigned
Jul 7, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 29, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 08001048 IN Primary

Addresses

Primary practice location

1178 Fremont CT
Elkhart, IN 46516-9321

Mailing address

1178 Fremont CT
Elkhart, IN 46516-9321
Phone (574) 293-7000

Other identifiers 3

IdentifierTypeStateIssuer
100113340AMedicaidIN
000000276845OtherINANTHEM BCBS PROVIDER #
4354978OtherINAETNA PROVIDER #

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111213000697 IN Practitioner - Chiropractic 1052351798 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
National College of Chiropractic, 1986
Medicare assignment
May accept Medicare assignment
Group practices
Schneider Clinic PCGroup PAC ID 9234179979, 2 clinicians

Practice addresses (Care Compare)

1178 Fremont CT
Suite 1
Elkhart, IN 46516-9321
Phone (574) 293-7000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
08001048INMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
MP Supports LLC CurrentSince Apr 20, 2020 Accepting new patients
MP Health PC CurrentSince Jul 14, 2020 Accepting new patients

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1152230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1301356800000",
    "number": "1659304525",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1178 FREMONT CT",
            "city": "ELKHART",
            "state": "IN",
            "postal_code": "465169321",
            "telephone_number": "574-293-7000",
            "fax_number": "574-293-7004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1178 FREMONT CT",
            "city": "ELKHART",
            "state": "IN",
            "postal_code": "465169321",
            "telephone_number": "574-293-7000",
            "fax_number": "574-293-7004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHNEIDER",
        "first_name": "MARK",
        "middle_name": "ALAN",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-07",
        "last_updated": "2011-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IN",
            "license": "08001048",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100113340A",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS PROVIDER #",
            "identifier": "000000276845",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA PROVIDER #",
            "identifier": "4354978",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Elkhart, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.