Individual provider Active NPI

Mark Thomas Huck, CHIROPRACTOR

  • Chiropractor
  • Tukwila, WA
National Provider Identifier
1912051145
Registry record updated Feb 27, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH00003356 Issued in WA
Practice address
7100 Fun Center Way
Suite 120
Tukwila, WA 98188-5540
Phone
(425) 251-3101
Fax
(425) 228-6566
NPI assigned
Jan 23, 2007
Last updated
Feb 27, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CH00003356 WA Primary
Chiropractor 111N00000X 813CHI MT

Addresses

Primary practice location

7100 Fun Center Way
Suite 120
Tukwila, WA 98188-5540

Mailing address

7100 Fun Center Way
Suite 120
Tukwila, WA 98188-5540
Phone (425) 251-3101

Other identifiers 1

IdentifierTypeStateIssuer
132063OtherWAL & I

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110119000489 WA Practitioner - Chiropractic 8628257946 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

7100 Fun Ctr Way
Suite 120
Tukwila, WA 98188-5540
Phone (425) 251-3101

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
813CHIMTMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Washington Chiropractic PLLC Chiropractor CurrentSince Nov 11, 2010 Accepting new patients

Locations

3459 S 152nd St
Tukwila, WA 98188
Phone (206) 241-2225

7100 Fun Center Way
Ste 120
Tukwila, WA 98188
Phone (425) 251-3101

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1169510400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1361923200000",
    "number": "1912051145",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7100 FUN CENTER WAY",
            "address_2": "SUITE 120",
            "city": "TUKWILA",
            "state": "WA",
            "postal_code": "981885540",
            "telephone_number": "425-251-3101",
            "fax_number": "425-228-6566"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7100 FUN CENTER WAY",
            "address_2": "SUITE 120",
            "city": "TUKWILA",
            "state": "WA",
            "postal_code": "981885540",
            "telephone_number": "425-251-3101",
            "fax_number": "425-228-6566"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUCK",
        "first_name": "MARK",
        "middle_name": "THOMAS",
        "name_prefix": "Dr.",
        "credential": "CHIROPRACTOR",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-23",
        "last_updated": "2013-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WA",
            "license": "CH00003356",
            "primary": true
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MT",
            "license": "813CHI",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "L & I",
            "identifier": "132063",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tukwila, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2013; 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.