Adderley Medical Group, L.L.C.

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

2007032281 Issued in MO

Legal business name

ADDERLEY MEDICAL GROUP, L.L.C.

Practice address

1400 US Highway 61
Festus, MO 63028-4100

Phone

(314) 288-9161

NPI assigned

Jul 27, 2010

Organization subpart

No

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

Authorized official

Name

Dr. Mark Floyd Adderley, D.O.NPI 1114149903

Title

Member

Phone

(314) 288-9161

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MO

Enrollment records 1

Locations

Practitioners 1

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

• Mark Floyd Adderley, D.O.

  • Physical Medicine & Rehabilitation Physician
  • Festus, MO
  • NPI 1114149903

  General Practice

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1280188800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1718150400000",
    "number": "1134433659",
    "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"
        },
        {
            "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": [],
    "basic": {
        "organization_name": "ADDERLEY MEDICAL GROUP, L.L.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-07-27",
        "last_updated": "2024-06-12",
        "certification_date": "2021-09-02",
        "status": "A",
        "authorized_official_last_name": "ADDERLEY",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "FLOYD",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "314-288-9161",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "General Practice",
            "state": "MO",
            "license": "2007032281",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Eilene K Acheson
• Acuity Anesthesiology LLC
• Deborah Kay Adair, LMSW
• Marsha Adams
• Susan S Adams, D.M.D.
• Mark Floyd Adderley, D.O.
• Advanced Anesthesia LLC
• Advanced Interior Construction LLC
• Advanced Psychiatric Services Inc
• Akr Endodontics, LLC

• General Practice Physician in Festus, MO
• Providers in Festus, MO by specialty
• General Practice 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.