Mark Carlson, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

098419 Issued in IA

Practice address

2377 Cumberland Square Dr
Bettendorf, IA 52722-3251

Phone

(563) 359-9541

Fax

(563) 344-3914

NPI assigned

Oct 2, 2019

Sex

Male

Sole proprietor

No

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.

• Galesburg Wellness Systems P.C.

  • Chiropractor
  • Galesburg, IL
  • NPI 1255813770
  NPD (past) CHIROPRACTOR

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Oct 2, 2019.

{
    "created_epoch": "1569974400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1569974400000",
    "number": "1801437694",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2377 CUMBERLAND SQUARE DR",
            "city": "BETTENDORF",
            "state": "IA",
            "postal_code": "527223251",
            "telephone_number": "563-359-9541",
            "fax_number": "563-344-3914"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2377 CUMBERLAND SQUARE DR",
            "city": "BETTENDORF",
            "state": "IA",
            "postal_code": "527223251",
            "telephone_number": "563-359-9541",
            "fax_number": "563-344-3914"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARLSON",
        "first_name": "MARK",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-10-02",
        "last_updated": "2019-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IA",
            "license": "098419",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• All providers in Bettendorf, IA
• Chiropractor in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.