Active NPI
Mark Flannery, D.C.
- Nutrition Chiropractor
- Simi Valley, CA
National Provider Identifier
1902076482
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nutrition Chiropractor
- License
- 30513
- Practice address
- 1919 Williams St
Suite 250
Simi Valley, CA 93065-2859 - Phone
- (805) 991-7455
- Fax
- (805) 991-7466
- NPI assigned
- Mar 11, 2008
- 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 |
|---|---|---|---|---|
| Nutrition Chiropractor | 111NN1001X | 30513 | CA | Primary |
Addresses
Primary practice location
1919 Williams St
Suite 250
Simi Valley, CA 93065-2859
Mailing address
1919 Williams St
Suite 250
Simi Valley, CA 93065-2859
Phone (805) 991-7455
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 |
|---|---|---|---|
| 30513 | CA | MD | Nutrition Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1205193600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1205193600000",
"number": "1902076482",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1919 WILLIAMS ST",
"address_2": "SUITE 250",
"city": "SIMI VALLEY",
"state": "CA",
"postal_code": "930652859",
"telephone_number": "805-991-7455",
"fax_number": "805-991-7466"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1919 WILLIAMS ST",
"address_2": "SUITE 250",
"city": "SIMI VALLEY",
"state": "CA",
"postal_code": "930652859",
"telephone_number": "805-991-7455",
"fax_number": "805-991-7466"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FLANNERY",
"first_name": "MARK",
"name_prefix": "Dr.",
"credential": "D.C.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2008-03-11",
"last_updated": "2008-03-11",
"status": "A"
},
"taxonomies": [
{
"code": "111NN1001X",
"taxonomy_group": "",
"desc": "Chiropractor, Nutrition",
"state": "CA",
"license": "30513",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Simi Valley, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.