NPIMap

Individual provider Active NPI

Mark Shannon Adkins, MD

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Kissimmee, FL
National Provider Identifier
1174610265
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianTaxonomy code 208G00000X
License
ME132078 Issued in FL
Practice address
720 W Oak St Ste 360
Kissimmee, FL 34741-4910
Phone
(407) 846-0090
Fax
(407) 846-0072
NPI assigned
Oct 9, 2006
Last updated
Jul 21, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician 208G00000X ME132078 FL Primary

Addresses

Primary practice location

720 W Oak St Ste 360
Kissimmee, FL 34741-4910

Mailing address

720 W Oak St Ste 360
Kissimmee, FL 34741-4910
Phone (407) 846-0090

Other identifiers 5

IdentifierTypeStateIssuer
2508605MedicaidNJ
021191400MedicaidFL
01077710MedicaidNY
3EIS3OtherFLBLUE CROSS BLUE SHIELD
02203YOtherNYGHI MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME132078FLMDThoracic Surgery (Cardiothoracic Vascular Surgery) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Tampa General Hospital Current Accepting new patients
Weill Medical College of Cornell Thoracic Surgery (Cardiothoracic Vascular Surgery) Past Accepting new patients
Weill Medical College of Cornell University Thoracic Surgery (Cardiothoracic Vascular Surgery) Past Accepting new patients

Interoperability endpoints

  • FHIR API: https://epicproxy.et0761.epichosted.com/FHIRProxy/api/FHIR/R4/
  • Direct secure messaging: madkins155367@direct.tgh.org

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1160352000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1174610265",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "720 W OAK ST STE 360",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347414910",
            "telephone_number": "407-846-0090",
            "fax_number": "407-846-0072"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "720 W OAK ST STE 360",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347414910",
            "telephone_number": "407-846-0090",
            "fax_number": "407-846-0072"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ADKINS",
        "first_name": "MARK",
        "middle_name": "SHANNON",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-09",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "FL",
            "license": "ME132078",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2508605",
            "state": "NJ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "021191400",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01077710",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "3EIS3",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHI MEDICARE",
            "identifier": "02203Y",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kissimmee, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.