Individual provider Active NPI

Mark Erich Allen, D.C.

  • Chiropractor
  • South Portland, ME
National Provider Identifier
1790768182
Registry record updated Dec 12, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CR1365 Issued in ME
Practice address
894 Broadway
South Portland, ME 04106-4350
Phone
(207) 699-2226
Fax
(207) 699-2229
NPI assigned
Nov 21, 2005
Last updated
Dec 12, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 12, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CR1365 ME Primary

Addresses

Primary practice location

894 Broadway
South Portland, ME 04106-4350

Mailing address

894 Broadway
South Portland, ME 04106-4350
Phone (207) 699-2226

Other identifiers 11

IdentifierTypeStateIssuer
M204600OtherMECIGNA
352582OtherMEHARVARD PILGRIM
522405696OtherMEMED NET SYSTEMS
177050000MedicaidME
522405696OtherMEHEALTH PLANS INC
640621OtherMEUNITED HEALTHCARE
2193260OtherMEFIRST HEALTH CARE SYSTEMS
4639291OtherMEAETNA
522405696OtherMEPRIVATE HEALTHCARE SYSTEM
522405696OtherMEPREFERREDONE ADMIN SERVIC
022415OtherMEANTHEM

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040209000972 ME Practitioner - Chiropractic 4486548708 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Life Chiropractic College, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

894 Broadway
South Portland, ME 04106-4350
Phone (207) 699-2226

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CR1365MEMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Advantage Chiropractic P a Chiropractor CurrentSince Jan 10, 2006 Accepting new patients
Preferred Chiropractic PLLC Chiropractor Past Accepting new patients
Preferred Chiropractic PLLC Chiropractor PastSince May 11, 2012 Accepting new patients
Shields Chiropractic LLC Chiropractor Past Accepting new patients
Caring Hands Chiropractic, P.C. Chiropractor Past Accepting new patients

Locations

894 Broadway
South Portland, ME 04106
Phone (207) 699-2226

Interoperability endpoints

  • Direct secure messaging: dr.allen@acp0009.direct.chirotouch.md

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1132531200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1355270400000",
    "number": "1790768182",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "894 BROADWAY",
            "city": "SOUTH PORTLAND",
            "state": "ME",
            "postal_code": "041064350",
            "telephone_number": "207-699-2226",
            "fax_number": "207-699-2229"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "894 BROADWAY",
            "city": "SOUTH PORTLAND",
            "state": "ME",
            "postal_code": "041064350",
            "telephone_number": "207-699-2226",
            "fax_number": "207-699-2229"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALLEN",
        "first_name": "MARK",
        "middle_name": "ERICH",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-21",
        "last_updated": "2012-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "ME",
            "license": "CR1365",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "M204600",
            "state": "ME"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HARVARD PILGRIM",
            "identifier": "352582",
            "state": "ME"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MED NET SYSTEMS",
            "identifier": "522405696",
            "state": "ME"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "177050000",
            "state": "ME"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH PLANS INC",
            "identifier": "522405696",
            "state": "ME"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "640621",
            "state": "ME"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIRST HEALTH CARE SYSTEMS",
            "identifier": "2193260",
            "state": "ME"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "4639291",
            "state": "ME"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PRIVATE HEALTHCARE SYSTEM",
            "identifier": "522405696",
            "state": "ME"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERREDONE ADMIN SERVIC",
            "identifier": "522405696",
            "state": "ME"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "022415",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in South Portland, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2012; 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.