Mark William Pegan, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

CH9620 Issued in FL

Practice address

365 Waymont CT
Suite 101
Lake Mary, FL 32746-3552

Phone

(407) 321-9191

NPI assigned

Dec 1, 2008

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 FL

Enrollment records 1

Specialty

Chiropractic

Education

Other, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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 and National Provider Directory roles.

• Heathrow Chiropractic Inc

  • Chiropractor
  • Lake Mary, FL
  • NPI 1083918023
  Medicare reassignment NPD Authorized official
• Wynne Chiropractic Inc.

  • Chiropractor
  • Lake Mary, FL
  • NPI 1669465571
  NPD (past)

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

{
    "created_epoch": "1228089600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1228089600000",
    "number": "1700031960",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1246 GLENCREST DR",
            "city": "HEATHROW",
            "state": "FL",
            "postal_code": "327465024",
            "telephone_number": "407-595-7191"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "365 WAYMONT CT",
            "address_2": "SUITE 101",
            "city": "LAKE MARY",
            "state": "FL",
            "postal_code": "327463552",
            "telephone_number": "407-321-9191"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEGAN",
        "first_name": "MARK",
        "middle_name": "WILLIAM",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-12-01",
        "last_updated": "2008-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH9620",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dyuti Peddapuli, PA-C
• Mary Sena Pederson, OTR/L
• Pediatric Potentials, Inc.
• Pediatrix Medical Group of Florida, Inc
• Pedro M. Ramirez MD PLLC
• Yufei Pei
• Deanne Josephine Pelliccio
• Rafael Eduardo Pena, MD
• Madison Lynn Penhaligon
• Darlin Perez Gonzalez

• Chiropractor in Lake Mary, FL
• Providers in Lake Mary, FL by specialty
• Chiropractor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2008; 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.