Active NPI
Mark Anthony Davini, D.C.
- Chiropractor
- S Yarmouth, MA
National Provider Identifier
1790974749
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- CH652
- Practice address
- 833 Route 28
S Yarmouth, MA 02664-5254 - Phone
- (508) 394-1353
- Fax
- (508) 398-2866
- NPI assigned
- Oct 16, 2007
- Last updated
- Mar 17, 2018
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | CH652 | MA | Primary |
| Neurology Chiropractor | 111NN0400X | CH652 | MA |
Addresses
Primary practice location
833 Route 28
S Yarmouth, MA 02664-5254
Mailing address
110 Beverly St
Apt 719
Boston, MA 02114-2124
Phone (508) 612-9087
Other practice location 1
110 Beverly St
Apt. 719
Boston, MA 02114-2124
Phone (857) 305-9490
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 652 | MA | MD | Mental Health Counselor |
| CH652 | MA | MD | Chiropractor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Agj Physical Therapy Associates, L.L.C. | Past | Accepting new patients |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Physical Therapist
- S Yarmouth, MA
- NPI 1679805899
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1192492800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1521244800000",
"number": "1790974749",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "110 BEVERLY ST",
"address_2": "APT 719",
"city": "BOSTON",
"state": "MA",
"postal_code": "021142124",
"telephone_number": "508-612-9087"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "833 ROUTE 28",
"city": "S YARMOUTH",
"state": "MA",
"postal_code": "026645254",
"telephone_number": "508-394-1353",
"fax_number": "508-398-2866"
}
],
"practiceLocations": [
{
"address_1": "110 Beverly St",
"address_2": "Apt. 719",
"address_purpose": "LOCATION",
"city": "Boston",
"state": "MA",
"postal_code": "021142124",
"country_code": "US",
"telephone_number": "857-305-9490",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "DAVINI",
"first_name": "MARK",
"middle_name": "ANTHONY",
"name_prefix": "Dr.",
"credential": "D.C.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-10-16",
"last_updated": "2018-03-17",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "MA",
"license": "CH652",
"primary": true
},
{
"code": "111NN0400X",
"taxonomy_group": "",
"desc": "Chiropractor, Neurology",
"state": "MA",
"license": "CH652",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in S Yarmouth, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.