Individual provider Active NPI

Mark Sherwood Liebich, D.C.

  • Chiropractor
  • Frisco, TX
National Provider Identifier
1912309113
Registry record updated Sep 18, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
12633 Issued in TX
Practice address
12398 FM 423 Ste 300
Frisco, TX 75033-0154
Phone
(615) 856-5542
NPI assigned
Sep 18, 2014
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 18, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 12633 TX Primary

Addresses

Primary practice location

12398 FM 423 Ste 300
Frisco, TX 75033-0154

Mailing address

12398 FM 423 Ste 300
Frisco, TX 75033-0154
Phone (615) 856-5542

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151013000316 TX Practitioner - Chiropractic 0042529109 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

12398 FM
423 Suite 300
Frisco, TX 75033-0154
Phone (214) 872-4220

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Beyond Innovation Chiropractic, LLC Chiropractor CurrentSince Aug 16, 2015 Accepting new patients

Locations

12398 FM 423
Ste 300
Frisco, TX 75033
Phone (214) 872-4220

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": "1410998400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1410998400000",
    "number": "1912309113",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12398 FM 423 STE 300",
            "city": "FRISCO",
            "state": "TX",
            "postal_code": "750330154",
            "telephone_number": "615-856-5542"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12398 FM 423 STE 300",
            "city": "FRISCO",
            "state": "TX",
            "postal_code": "750330154",
            "telephone_number": "615-856-5542"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIEBICH",
        "first_name": "MARK",
        "middle_name": "SHERWOOD",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-09-18",
        "last_updated": "2014-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "TX",
            "license": "12633",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Frisco, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2014; 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.