NPIMap

Organization Active NPI

Mark V. Walters DC PC

  • Chiropractor
  • Mount Vernon, MO
National Provider Identifier
1821366550
Registry record updated Dec 8, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
006467 Issued in MO
Legal business name
MARK V. WALTERS DC PC
Practice address
316 W Mount Vernon Blvd
Mount Vernon, MO 65712-1940
Phone
(417) 461-1155
Fax
(417) 461-1155
NPI assigned
Dec 8, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 8, 2011

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

Authorized official

Name
Dr. Mark V Walters, D.CNPI 1285794990
Title
Owner/Operator
Phone
(417) 461-1155

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193200000X MULTI-SPECIALTY GROUP 111N00000X 006467 MO Primary

Addresses

Primary practice location

316 W Mount Vernon Blvd
Mount Vernon, MO 65712-1940

Mailing address

316 W Mount Vernon Blvd
Mount Vernon, MO 65712-1940
Phone (417) 461-1155

Other identifiers 2

IdentifierTypeStateIssuer
315015486OtherMOMEDICARE PTAN
350039075OtherMORAILROAD MEDICARE

National Provider Directory

National Provider Directory
Tax ID family
Mark V Walters DC PC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1323302400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1323302400000",
    "number": "1821366550",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "316 W MOUNT VERNON BLVD",
            "city": "MOUNT VERNON",
            "state": "MO",
            "postal_code": "657121940",
            "telephone_number": "417-461-1155",
            "fax_number": "417-461-1155"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "316 W MOUNT VERNON BLVD",
            "city": "MOUNT VERNON",
            "state": "MO",
            "postal_code": "657121940",
            "telephone_number": "417-461-1155",
            "fax_number": "417-461-1155"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARK V. WALTERS DC PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-12-08",
        "last_updated": "2011-12-08",
        "status": "A",
        "authorized_official_last_name": "WALTERS",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "V",
        "authorized_official_title_or_position": "OWNER/OPERATOR",
        "authorized_official_telephone_number": "417-461-1155",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "MO",
            "license": "006467",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "315015486",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "350039075",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Vernon, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 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.

Verify at the official NPI Registry.