Dyllon Mawn, DC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

CH13631 Issued in FL

Practice address

2500 1St Ave N
Saint Petersburg, FL 33713-8702

Phone

(727) 329-6106

NPI assigned

Feb 18, 2022

Last updated

Nov 6, 2023By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Mawn Chiropractic PA

  dba The Source Chiropractic

  • Chiropractor
  • St Petersburg, FL
  • NPI 1306418678
  NPD Authorized official

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

{
    "created_epoch": "1645142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699228800000",
    "number": "1053066910",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5751 11TH ST S",
            "city": "SAINT PETERSBURG",
            "state": "FL",
            "postal_code": "337055021",
            "telephone_number": "561-876-2157"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 1ST AVE N",
            "city": "SAINT PETERSBURG",
            "state": "FL",
            "postal_code": "337138702",
            "telephone_number": "727-329-6106"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAWN",
        "first_name": "DYLLON",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-02-18",
        "last_updated": "2023-11-06",
        "certification_date": "2023-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH13631",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Daniel Anthony Mauriello, M.D.
• Anastasios Mavrakis, MD
• Brian Lawrence Mavretich, DO
• Angelia Fletcher Mavros
• Mawn Chiropractic PA (The Source Chiropractic)
• Max Day PLLC
• Trevor Maxfield, BCBA
• Maxicare
• Marisa Maximous, RBT
• Timmi Maxmillian, DO

• Chiropractor in St Petersburg, FL
• Providers in St Petersburg, FL by specialty
• Chiropractor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2023; 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.