Jeffery a Mark PC

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

01039223A Issued in IN

Legal business name

JEFFERY A MARK PC

Practice address

515 S 2ND St
Elkhart, IN 46516-3224

Phone

(574) 295-4141

NPI assigned

Nov 29, 2011

Last updated

Nov 29, 2011By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Jeff Mark

Title

Owner

Phone

(574) 295-4141

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1322524800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1322524800000",
    "number": "1972870491",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "515 S 2ND STREET",
            "city": "ELKHART",
            "state": "IN",
            "postal_code": "46516",
            "telephone_number": "574-295-4141"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "515 S 2ND ST",
            "city": "ELKHART",
            "state": "IN",
            "postal_code": "465163224",
            "telephone_number": "574-295-4141"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JEFFERY A MARK PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-11-29",
        "last_updated": "2011-11-29",
        "status": "A",
        "authorized_official_last_name": "MARK",
        "authorized_official_first_name": "JEFF",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "574-295-4141"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery",
            "state": "IN",
            "license": "01039223A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100114070B",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Carol A. Jarvis, PH.D., LCSW
• Douglas L. Jarvis, D.O.
• James Robert Jastifer, MD
• Kamran Javaid, M.D.
• JCB Anesthesia & Pain Management, PC (Comprehensive Pain Clinic and Wellness Center)
• Danny Jennings
• Samantha Lynn Jester, CNM
• Ignacio Jimenez
• Leory Jimenez
• Scott Johns, CRNA

• Surgery Physician in Elkhart, IN
• Providers in Elkhart, IN by specialty
• Surgery Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.