Julie P. Mark, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

01036572A Issued in IN

Practice address

1627 E Bristol St
Elkhart, IN 46514-3817

Phone

(574) 262-0313

Fax

(574) 262-8163

NPI assigned

Jan 28, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1422403200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1458259200000",
    "number": "1851781934",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "710 N NILES AVE",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466171924",
            "telephone_number": "574-647-1610"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1627 E BRISTOL ST",
            "city": "ELKHART",
            "state": "IN",
            "postal_code": "465143817",
            "telephone_number": "574-262-0313",
            "fax_number": "574-262-8163"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARK",
        "first_name": "JULIE",
        "middle_name": "P.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-01-28",
        "last_updated": "2016-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IN",
            "license": "01036572A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS BMG PEDIATRICS",
            "identifier": "000000924711",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100130050",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jodi Mann, RPT
• Sonia Mantilla, PT
• Jeneba Marcus
• Marion Associates, P.C.
• Mark Corn DDS PC
• Wesley Ray Mark, DDS MS
• Evelyn Marquez
• Abigail Marron
• Brandon Keith Martin, CRNA
• Heather Martin, LMHC

• Pediatrics Physician in Elkhart, IN
• Providers in Elkhart, IN by specialty
• Pediatrics Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2016; 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.