Mark R Ofenloch, PH.D

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

P0000001005 Issued in TN

Practice address

1273 Dayton Mountain Hwy
Dayton, TN 37321-2816

Phone

(423) 570-1900

Fax

(423) 570-0008

NPI assigned

Oct 5, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

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.

• We Care Individual and Family Service Center Inc.

  • Cognitive & Behavioral Psychologist
  • Dayton, TN
  • NPI 1225124209
  NPD

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

{
    "created_epoch": "1160006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1992891022",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 307",
            "city": "DAYTON",
            "state": "TN",
            "postal_code": "373210307",
            "telephone_number": "423-570-1900",
            "fax_number": "423-570-0008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1273 DAYTON MOUNTAIN HWY",
            "city": "DAYTON",
            "state": "TN",
            "postal_code": "373212816",
            "telephone_number": "423-570-1900",
            "fax_number": "423-570-0008"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OFENLOCH",
        "first_name": "MARK",
        "middle_name": "R",
        "credential": "PH.D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "TN",
            "license": "P0000001005",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS/BLUE SHIELD",
            "identifier": "4024807",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3685725",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Nicole J. Kammeyer, O.D.
• Ocoee Regional Health Corporation
• Ocoee Regional Health Corporation
• Ocoee Regional Health Corporation
• Ocoee Regional Health Corporation
• Opulent Healthcare
• Kathryn Orten, PA-C
• Sharon Eileen Oxentenko, M.S.
• Sarah Parker
• Niki Patel

• All providers in Dayton, TN
• Clinical Psychologist in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.