Organization Active NPI

Hallmark Chiropractic

  • Chiropractor
  • Riverhead, NY
National Provider Identifier
1942248489
Registry record updated Mar 8, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
X007337-1 Issued in NY
Legal business name
HALLMARK CHIROPRACTIC
Practice address
633 Roanoke Ave
Riverhead, NY 11901-2727
Phone
(631) 727-3795
Fax
(631) 727-1961
NPI assigned
Jun 4, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 8, 2011

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

Authorized official

Name
Dr. Glen Mark, D.C.NPI 1669415238
Title
Partner
Phone
(631) 727-3795

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X X007337-1 NY Primary

Addresses

Primary practice location

633 Roanoke Ave
Riverhead, NY 11901-2727

Mailing address

633 Roanoke Ave
Riverhead, NY 11901-2727
Phone (631) 727-3795

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040917000189 NY Part B Supplier - Clinic/Group Practice 2264400308 Receives reassigned benefits from 2 practitioners
Practice locations: Riverhead, NY

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1149379200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1299542400000",
    "number": "1942248489",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "633 ROANOKE AVE",
            "city": "RIVERHEAD",
            "state": "NY",
            "postal_code": "119012727",
            "telephone_number": "631-727-3795",
            "fax_number": "631-727-1961"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "633 ROANOKE AVE",
            "city": "RIVERHEAD",
            "state": "NY",
            "postal_code": "119012727",
            "telephone_number": "631-727-3795",
            "fax_number": "631-727-1961"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HALLMARK CHIROPRACTIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-04",
        "last_updated": "2011-03-08",
        "status": "A",
        "authorized_official_last_name": "MARK",
        "authorized_official_first_name": "GLEN",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "631-727-3795",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "NY",
            "license": "X007337-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Riverhead, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.