Individual provider Active NPI

Mark William Hogue, DC

  • Chiropractor
  • Shelby, OH
National Provider Identifier
1760521686
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
1448 Issued in OH
Practice address
100 North Gamble Street
Shelby, OH 44875
Phone
(419) 342-2931
Fax
(419) 347-7096
NPI assigned
Feb 6, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 1448 OH Primary

Addresses

Primary practice location

100 North Gamble Street
Shelby, OH 44875

Mailing address

100 North Gamble Street
Shelby, OH 44875
Phone (419) 342-2931

Other identifiers 1

IdentifierTypeStateIssuer
0738689MedicaidOH

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120413000084 OH Practitioner - Chiropractic 3072774371 Practice locations: Shelby, OH

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Life Chiropractic College, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

142 N Gamble St
Suite B
Shelby, OH 44875-2114
Phone (419) 342-2931

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
1448OHMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Shelby Home & Public Health, Inc. Past Accepting new patients
Shelby Home & Public Health, Inc. Past Accepting new patients

Organizations & group practices 2

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": "1170720000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1760521686",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 NORTH GAMBLE STREET",
            "city": "SHELBY",
            "state": "OH",
            "postal_code": "44875",
            "telephone_number": "419-342-2931",
            "fax_number": "419-347-7096"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 NORTH GAMBLE STREET",
            "city": "SHELBY",
            "state": "OH",
            "postal_code": "44875",
            "telephone_number": "419-342-2931",
            "fax_number": "419-347-7096"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOGUE",
        "first_name": "MARK",
        "middle_name": "WILLIAM",
        "name_prefix": "Mr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-06",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "OH",
            "license": "1448",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0738689",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Shelby, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.