Mark S Slaughter, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

Practice address

219 2ND Ave.
Suite C
Edwardsville, IL 62025-2556

Phone

(618) 656-5433

Fax

(618) 656-5437

NPI assigned

Sep 2, 2006

Last updated

Feb 1, 2008By the provider in NPPES

Sex

Male

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 6

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Saint Louis University School of Medicine, 1993

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Mark Slaughter PC

  • Physical Therapist
  • Edwardsville, IL
  • NPI 1922129352
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1157155200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1201824000000",
    "number": "1912009739",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "219 2ND AVE.",
            "address_2": "SUITE C",
            "city": "EDWARDSVILLE",
            "state": "IL",
            "postal_code": "620252556",
            "telephone_number": "618-656-5433",
            "fax_number": "618-656-5437"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "219 2ND AVE.",
            "address_2": "SUITE C",
            "city": "EDWARDSVILLE",
            "state": "IL",
            "postal_code": "620252556",
            "telephone_number": "618-656-5433",
            "fax_number": "618-656-5437"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SLAUGHTER",
        "first_name": "MARK",
        "middle_name": "S",
        "name_prefix": "Mr.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-02",
        "last_updated": "2008-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "06032038",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00019088",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "4650113",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "167276",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHLINK",
            "identifier": "514168",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "6400479",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Cassandra Sissom, L.P.C., L.C.P.C.
• Siu Dental Associates
• Carissa Lyne Skaggs, RN
• Stacy Skelton, RN
• Stacey Michelle Skillman Holtgrave
• Judy Ann Slosar
• Alexander Joseph Smith
• Brandy Lynn Smith, LCPC
• Jason Smith, NP
• Vanessa Smith

• Physical Therapist in Edwardsville, IL
• Providers in Edwardsville, IL by specialty
• Physical Therapist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2008; 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.