Individual provider Active NPI

Mark Taylor Langenberg, M.D.

  • Pediatrics Physician
  • Livingston, TN
National Provider Identifier
1891759767
Registry record updated Jun 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
35093 Issued in TN
Practice address
500 W Main St
Livingston, TN 38570-1718
Phone
(931) 823-5681
Fax
(931) 823-8203
NPI assigned
Apr 17, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 6, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 35093 TN Primary
Internal Medicine Physician 207R00000X 35093 TN

Addresses

Primary practice location

500 W Main St
Livingston, TN 38570-1718

Mailing address

500 W Main St
Livingston, TN 38570-1718
Phone (931) 823-5681

Other identifiers 1

IdentifierTypeStateIssuer
3875548MedicaidTN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100115000488 TN Practitioner - Internal MedicinePractitioner - Pediatric Medicine 4587706452 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Pediatric Medicine
Education
University of Tennessee, HSC, College of Medicine, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Amg-Livingston LLCGroup PAC ID 1052225760, 18 clinicians

Practice addresses (Care Compare)

500 W Main St
Livingston, TN 38570-1718
Phone (931) 823-5681

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
35093TNMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Amg - Livingston, LLC CurrentSince Jul 1, 2015 Accepting new patients
Amg- Livingston LLC CurrentSince Jul 1, 2015 Accepting new patients
Amg-Livingston LLC Current Accepting new patients
Livingston Regional Hospital LLC Past Accepting new patients

Locations

500 W Main St
Livingston, TN 38570
Phone (931) 823-4016

Interoperability endpoints

  • Direct secure messaging: langenburg_mark_t_-_physician_-_fixed@yourcarecommunity.org
  • Direct secure messaging: mark.langenberg.1@25766.direct.athenahealth.com

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": "1145232000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717632000000",
    "number": "1891759767",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 W MAIN ST",
            "city": "LIVINGSTON",
            "state": "TN",
            "postal_code": "385701718",
            "telephone_number": "931-823-5681",
            "fax_number": "931-823-7235"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 W MAIN ST",
            "city": "LIVINGSTON",
            "state": "TN",
            "postal_code": "385701718",
            "telephone_number": "931-823-5681",
            "fax_number": "931-823-8203"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANGENBERG",
        "first_name": "MARK",
        "middle_name": "TAYLOR",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-17",
        "last_updated": "2024-06-06",
        "certification_date": "2024-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TN",
            "license": "35093",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TN",
            "license": "35093",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3875548",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Livingston, TN

Sources for this page

Verify at the official NPI Registry.