Active NPI
Mark Edward Lazenby, D.C.
- Chiropractor
- Blytheville, AR
National Provider Identifier
1811009285
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 1147
- Practice address
- 506 Park St
Blytheville, AR 72315-2424 - Phone
- (870) 762-2825
- Fax
- (870) 762-2825
- NPI assigned
- Aug 31, 2006
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 1147 | AR | Primary |
Addresses
Primary practice location
506 Park St
Blytheville, AR 72315-2424
Mailing address
506 Park St
Blytheville, AR 72315-2424
Phone (870) 762-2825
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1147 | AR | MD | Chiropractor |
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": "1295308800000",
"number": "1811009285",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "506 PARK ST",
"city": "BLYTHEVILLE",
"state": "AR",
"postal_code": "723152424",
"telephone_number": "870-762-2825",
"fax_number": "870-762-2825"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "506 PARK ST",
"city": "BLYTHEVILLE",
"state": "AR",
"postal_code": "723152424",
"telephone_number": "870-762-2825",
"fax_number": "870-762-2825"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LAZENBY",
"first_name": "MARK",
"middle_name": "EDWARD",
"name_prefix": "Dr.",
"credential": "D.C.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-08-31",
"last_updated": "2011-01-18",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "AR",
"license": "1147",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Blytheville, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.