Individual provider Active NPI

Bruce Mark, DC

  • Chiropractor
  • Hollywood, FL
National Provider Identifier
1811008568
Registry record updated Jul 31, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH7442 Issued in FL
Practice address
2607 Polk St
Hollywood, FL 33020
Phone
(954) 925-7333
Fax
(954) 925-7339
NPI assigned
Aug 31, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 10266 TX
Chiropractor 111N00000X CH7442 FL Primary

Addresses

Primary practice location

2607 Polk St
Hollywood, FL 33020

Mailing address

2607 Polk St
Hollywood, FL 33020-4822
Phone (954) 925-7333

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090106000620 FL Practitioner - Chiropractic 7810099835 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Logan College of Chiropractic, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Broward Medical and Rehab IncGroup PAC ID 0840326104, 2 clinicians

Practice addresses (Care Compare)

5000 W Oakland Park Blvd
Lauderdale Lakes, FL 33313-1503
Phone (954) 735-6000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
10266TXMDProfessional Counselor
CH7442FLMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Broward Medical & Rehab Inc Chiropractor CurrentSince Sep 20, 2009 Accepting new patients
Midway Medical Associates PA Past Accepting new patients
Steven L. Weiner, DC, PA Chiropractor PastSince Jan 10, 1994 Accepting new patients
Parker University Chiropractor PastSince Sep 1, 2005 Accepting new patients

Locations

2607 Polk St
Hollywood, FL 33020
Phone (954) 925-4001

5000 W Oakland Park Blvd
Lauderdale Lakes, FL 33313
Phone (866) 747-5834

4101 NW 4th St
Ste 305
Plantation, FL 33317
Phone (954) 370-7040

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/23964/brand/1/csg/1/fhir/r4

Organizations & group practices 4

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": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1532995200000",
    "number": "1811008568",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2607 POLK ST",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330204822",
            "telephone_number": "954-925-7333",
            "fax_number": "954-925-7339"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2607 POLK ST",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "33020",
            "telephone_number": "954-925-7333",
            "fax_number": "954-925-7339"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARK",
        "first_name": "BRUCE",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-31",
        "last_updated": "2018-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "TX",
            "license": "10266",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH7442",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hollywood, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2018; 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.