Individual provider Active NPI

Mark Wade, DC

  • Chiropractor
  • Pinellas Park, FL
National Provider Identifier
1407635196
Registry record updated Jul 29, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH14706 Issued in FL
Practice address
6425 53Rd St N Ste 6
Pinellas Park, FL 33781-5629
Phone
(727) 233-5268
NPI assigned
Sep 22, 2023
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 29, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CH14706 FL Primary

Addresses

Primary practice location

6425 53Rd St N Ste 6
Pinellas Park, FL 33781-5629

Mailing address

225 1St Ave N Unit 2201
St Petersburg, FL 33701-3739
Phone (727) 685-8464

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240611001717 FL Practitioner - Chiropractic 9537601109 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CH14706FLMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Royal Palm Beach Rehab, Corp Chiropractor CurrentSince Nov 10, 2025 Accepting new patients
Royal Palm Beach Rehab, Corp Chiropractor Current Accepting new patients
Royal Palm Beach Rehab Corp Chiropractor CurrentSince Nov 10, 2025 Accepting new patients

Locations

4971 Le Chalet Blvd
Ste 100
Boynton Beach, FL 33436
Phone (561) 733-5590

6912 Asphalt Ave
Tampa, FL 33614
Phone (262) 488-0118

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1695340800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785283200000",
    "number": "1407635196",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "225 1ST AVE N UNIT 2201",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337013739",
            "telephone_number": "727-685-8464"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6425 53RD ST N STE 6",
            "city": "PINELLAS PARK",
            "state": "FL",
            "postal_code": "337815629",
            "telephone_number": "727-233-5268"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WADE",
        "first_name": "MARK",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-09-22",
        "last_updated": "2026-07-29",
        "certification_date": "2026-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH14706",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pinellas Park, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2026; 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.