Mark Floyd Adderley, D.O.

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

License

2007032281 Issued in MO

Practice address

1400 US Highway 61
Festus, MO 63028-4100

Phone

(314) 288-9161

NPI assigned

May 3, 2007

Last updated

Jun 12, 2024By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MO

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physical Medicine and RehabilitationAlso: General Practice

Education

Other, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Hospital & facility affiliations

• Scenic Wellness and Rehabilitation Center Nursing home, Herculaneum, MO, CCN 265216

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

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

• Adderley Medical Group, L.L.C.

  • General Practice Physician
  • Festus, MO
  • NPI 1134433659
  Medicare reassignment NPD Authorized official
• Fieser Nursing Center LLC

  dba Fieser Nursing Center

  • Nursing Facility/Intermediate Care Facility
  • Fenton, MO
  • NPI 1073693826
  NPD (past)
• Gavini Medical Group,LTD

  • General Practice Physician
  • Saint Louis, MO
  • NPI 1912014606
  NPD (past)
• Scenic Nursing and Rehabilitation Center, LLC

  • Skilled Nursing Facility
  • Herculaneum, MO
  • NPI 1346315975
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Scenic Nursing and Rehabilitation Center, LLC

  • Skilled Nursing Facility
  • Herculaneum, MO
  • NPI 1346315975

  Nursing home

  Care Compare affiliation

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

{
    "created_epoch": "1178150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718150400000",
    "number": "1114149903",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4770 OLD SCHOOL TRL",
            "city": "HILLSBORO",
            "state": "MO",
            "postal_code": "630504929",
            "telephone_number": "314-288-9161",
            "fax_number": "314-868-8576"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 US HIGHWAY 61",
            "city": "FESTUS",
            "state": "MO",
            "postal_code": "630284100",
            "telephone_number": "314-288-9161"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1333 Scenic Dr",
            "address_purpose": "LOCATION",
            "city": "Herculaneum",
            "state": "MO",
            "postal_code": "630481550",
            "country_code": "US",
            "telephone_number": "314-288-9161",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1 Jefferson Barracks Dr",
            "address_purpose": "LOCATION",
            "city": "Saint Louis",
            "state": "MO",
            "postal_code": "631254181",
            "country_code": "US",
            "telephone_number": "314-894-6605",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ADDERLEY",
        "first_name": "MARK",
        "middle_name": "FLOYD",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-03",
        "last_updated": "2024-06-12",
        "certification_date": "2024-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "MO",
            "license": "2007032281",
            "primary": true
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "MO",
            "license": "2007032281",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Acuity Anesthesiology LLC
• Deborah Kay Adair, LMSW
• Marsha Adams
• Susan S Adams, D.M.D.
• Adderley Medical Group, L.L.C.
• Advanced Anesthesia LLC
• Advanced Interior Construction LLC
• Advanced Psychiatric Services Inc
• Akr Endodontics, LLC (Endodontic Associates)
• Elizabeth Al Bayati

• Physical Medicine & Rehabilitation Physician in Festus, MO
• Providers in Festus, MO by specialty
• Physical Medicine & Rehabilitation Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2024; 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.
• 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.