Active NPI
Mark Allen Roberts, D.C.
- Chiropractor
- Lufkin, TX
National Provider Identifier
1710968052
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 8855
- Practice address
- 1404 W Frank Ave
Lufkin, TX 75904-3306 - Phone
- (936) 634-8461
- Fax
- (936) 634-8524
- NPI assigned
- Nov 11, 2005
- Last updated
- Oct 12, 2016
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 8855 | TX | Primary |
Addresses
Primary practice location
1404 W Frank Ave
Lufkin, TX 75904-3306
Mailing address
1404 W Frank Avenue
Lufkin, TX 75904-3301
Phone (936) 634-8461
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| P000607850 | Other | TX | RAILROAD RETIREMENT |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20050825001034 | TX | Practitioner - Chiropractic | 3678504933 | Practice locations: Lufkin, TX |
Care Compare profile
Medicare Care Compare- Specialty
- Chiropractic
- Education
- Other, 2000
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
1404 W Frank Ave
Lufkin, TX 75904-3306
Phone (936) 634-8461
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 8855 | TX | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Past | Accepting new patients | |
| Walgreen Co | Past | Accepting new patients |
Organizations & group practices 4
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Roberts Chiropractic and Acupuncture
- Chiropractor
- Lufkin, TX
- NPI 1265778898
-
- Chiropractor
- Lufkin, TX
- NPI 1700396561
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1131667200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1476230400000",
"number": "1710968052",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1404 W FRANK AVENUE",
"city": "LUFKIN",
"state": "TX",
"postal_code": "759043301",
"telephone_number": "936-634-8461",
"fax_number": "936-634-8524"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1404 W FRANK AVE",
"city": "LUFKIN",
"state": "TX",
"postal_code": "759043306",
"telephone_number": "936-634-8461",
"fax_number": "936-634-8524"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROBERTS",
"first_name": "MARK",
"middle_name": "ALLEN",
"name_prefix": "Dr.",
"credential": "D.C.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-11-11",
"last_updated": "2016-10-12",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "TX",
"license": "8855",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD RETIREMENT",
"identifier": "P000607850",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Lufkin, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2016; 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.