Kolten Pedigo, DC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

038.013487 Issued in IL

Practice address

1616 W Main St Ste 200
Marion, IL 62959-1146

Phone

(618) 772-2999

NPI assigned

Jan 2, 2020

Last updated

Mar 26, 2026By 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 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Specialty

Chiropractic

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• Southern Spine & Rehab, PLLC

  • Clinic/Center
  • Marion, IL
  • NPI 1083254734
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1577923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1774483200000",
    "number": "1568001907",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1616 W MAIN ST STE 200",
            "city": "MARION",
            "state": "IL",
            "postal_code": "629591146"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1616 W MAIN ST STE 200",
            "city": "MARION",
            "state": "IL",
            "postal_code": "629591146",
            "telephone_number": "618-772-2999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEDIGO",
        "first_name": "KOLTEN",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-01-02",
        "last_updated": "2026-03-26",
        "certification_date": "2026-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038.013487",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michelle Patula, CPM
• Lindy Payne, APRN
• Matthew Payne
• Myronda Beth Pearson
• Pediatric Group LLC
• Rocky Ray Peppers Sr., LCSW
• Performance Chiropractic of Southern Illinois LLC
• Renae Peter, M.S, SLP-CCC
• Destiny Grace Petrowich, PA-C
• Angela Phelps, RN

• Chiropractor in Marion, IL
• Providers in Marion, IL by specialty
• Chiropractor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.