Mark Leslie Huntsman, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

CHIR008712 Issued in GA

Practice address

205 Old Blackstone Camp Rd
Martinez, GA 30907-9459

Phone

(706) 814-5053

NPI assigned

Jun 5, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Specialty

Chiropractic

Education

Logan College of Chiropractic, 2005

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Georgia Clinic of Chiropractic, LLC

  • Chiropractor
  • Martinez, GA
  • NPI 1538478508
  Medicare reassignment NPD Authorized official
• Midwest Clinic of Chiropractic, P.C.

  • Chiropractor
  • Crest Hill, IL
  • NPI 1285962662
  NPD (past) Authorized official
• Alvi Medical Services SC

  • Internal Medicine Physician
  • Crest Hill, IL
  • NPI 1720229677
  NPD (past)

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

{
    "created_epoch": "1149465600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1318982400000",
    "number": "1699714808",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "205 OLD BLACKSTONE CAMP RD",
            "city": "MARTINEZ",
            "state": "GA",
            "postal_code": "309079459",
            "telephone_number": "706-814-5053"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 OLD BLACKSTONE CAMP RD",
            "city": "MARTINEZ",
            "state": "GA",
            "postal_code": "309079459",
            "telephone_number": "706-814-5053"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUNTSMAN",
        "first_name": "MARK",
        "middle_name": "LESLIE",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-05",
        "last_updated": "2011-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "GA",
            "license": "CHIR008712",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "085YE",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Chiropractor in Martinez, GA
• Providers in Martinez, GA by specialty
• Chiropractor in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 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.