Individual provider Active NPI

Mark Douglas Maeyaert, D.C.

  • Chiropractor
  • Spirit Lake, IA
National Provider Identifier
1720422744
Registry record updated Feb 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
007652 Issued in IA
Practice address
2220 33Rd St Ste a
Spirit Lake, IA 51360-7715
Phone
(712) 336-4848
Fax
(712) 336-4980
NPI assigned
Apr 21, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 7, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 007652 IA Primary

Addresses

Primary practice location

2220 33Rd St Ste a
Spirit Lake, IA 51360-7715

Mailing address

2220 33Rd St Ste a
Spirit Lake, IA 51360-7715
Phone (712) 336-4848

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130801000775 IA Practitioner - Chiropractic 0143461145 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2220 33Rd St
Suite a
Spirit Lake, IA 51360-7715
Phone (712) 336-4848

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Elite Health & Wellness P.C. Chiropractor CurrentSince May 1, 2013 Accepting new patients

Locations

3301 Highway 71
Ste 1
Spirit Lake, IA 51360
Phone (712) 332-6001

2220 33rd St
Ste A
Spirit Lake, IA 51360
Phone (507) 530-8406

Organizations & group practices 1

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": "1366502400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707264000000",
    "number": "1720422744",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2220 33RD ST STE A",
            "city": "SPIRIT LAKE",
            "state": "IA",
            "postal_code": "513607715",
            "telephone_number": "712-336-4848",
            "fax_number": "712-336-4980"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2220 33RD ST STE A",
            "city": "SPIRIT LAKE",
            "state": "IA",
            "postal_code": "513607715",
            "telephone_number": "712-336-4848",
            "fax_number": "712-336-4980"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAEYAERT",
        "first_name": "MARK",
        "middle_name": "DOUGLAS",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-04-21",
        "last_updated": "2024-02-07",
        "certification_date": "2024-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IA",
            "license": "007652",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Spirit Lake, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2024; 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.