Individual provider Active NPI

Mark R. Winteregg, D.C.

  • Orthopedic Chiropractor
  • Fort Wayne, IN
National Provider Identifier
1881697795
Registry record updated Nov 27, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopedic ChiropractorTaxonomy code 111NX0800X
License
08001604A Issued in IN
Practice address
10315 Dawsons Creek Blvd
Ste I
Fort Wayne, IN 46825-1912
Phone
(260) 490-3400
Fax
(260) 489-5930
NPI assigned
May 24, 2005
Reactivated
Mar 21, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 27, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopedic Chiropractor 111NX0800X 08001604A IN Primary

Addresses

Primary practice location

10315 Dawsons Creek Blvd
Ste I
Fort Wayne, IN 46825-1912

Mailing address

10315 Dawsons Creek Blvd
Ste I
Fort Wayne, IN 46825-1912
Phone (260) 490-3400

Other identifiers 1

IdentifierTypeStateIssuer
000000092552OtherINBLUE CROSS/BLUE SHIELD

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100415000261 IN Practitioner - Chiropractic 4385771849 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
National College of Chiropractic, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dupont Family Chiropractic PCGroup PAC ID 0042347502, 2 clinicians

Practice addresses (Care Compare)

10315 Dawsons Creek Blvd
Suite I
Fort Wayne, IN 46825-1912
Phone (260) 490-3400

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Dupont Family Chiropractic PC CurrentSince Apr 15, 2010 Accepting new patients

Locations

10315 Dawsons Creek Blvd
Ste I
Fort Wayne, IN 46825
Phone (260) 490-3400

Organizations & group practices 1

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": "1116892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1196121600000",
    "number": "1881697795",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10315 DAWSONS CREEK BLVD",
            "address_2": "STE I",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468251912",
            "telephone_number": "260-490-3400",
            "fax_number": "260-489-5930"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10315 DAWSONS CREEK BLVD",
            "address_2": "STE I",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468251912",
            "telephone_number": "260-490-3400",
            "fax_number": "260-489-5930"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WINTEREGG",
        "first_name": "MARK",
        "middle_name": "R.",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-05-24",
        "last_updated": "2007-11-27",
        "deactivation_date": "2006-03-16",
        "reactivation_date": "2006-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NX0800X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Orthopedic",
            "state": "IN",
            "license": "08001604A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS/BLUE SHIELD",
            "identifier": "000000092552",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Wayne, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2007; 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.