Mark Pequignot, DNP FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

10010332 Issued in OR

Practice address

1700 NW Garden Valley Blvd Ste 201
Roseburg, OR 97471-1636

Phone

(541) 236-9246

Fax

(541) 464-0789

NPI assigned

May 2, 2023

Last updated

Mar 1, 2024By 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 OR

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Nisha Jackson IncGroup PAC ID 6305147745, 47 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Mercy Medical Center Hospital, Roseburg, OR, CCN 380027
• Bay Area Hospital Hospital, Coos Bay, OR, CCN 380090

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Interoperability endpoints

• Direct secure messaging: mark.peqignot.p1@direct.opm.nextgenshare.com

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.

• Nisha Jackson PC

  • Nurse Practitioner
  • Medford, OR
  • NPI 1124499124
  Medicare reassignment Care Compare group

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Bay Area Hospital District

  dba Bay Area Hospital

  • General Acute Care Hospital
  • Coos Bay, OR
  • NPI 1225016561
  Care Compare affiliation
• Commonspirit Oregon

  dba CHI Mercy Medical Center

  • General Acute Care Hospital
  • Roseburg, OR
  • NPI 1477590198
  Care Compare affiliation

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

{
    "created_epoch": "1682985600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709251200000",
    "number": "1770272148",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1700 NW GARDEN VALLEY BLVD STE 201",
            "city": "ROSEBURG",
            "state": "OR",
            "postal_code": "974711636",
            "telephone_number": "541-236-9246",
            "fax_number": "541-464-0789"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 NW GARDEN VALLEY BLVD STE 201",
            "city": "ROSEBURG",
            "state": "OR",
            "postal_code": "974711636",
            "telephone_number": "541-236-9246",
            "fax_number": "541-464-0789"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEQUIGNOT",
        "first_name": "MARK",
        "credential": "DNP  FNP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-05-02",
        "last_updated": "2024-03-01",
        "certification_date": "2024-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OR",
            "license": "10010332",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tiffany Paz
• Trisha Joann Pederson
• Mark Pedginski
• Misha Marie Peel, DO
• Shelby Rose Pehlke
• Alexia Jannet Perez, MSW,MS,LCSW
• Armando Perez
• Jody Perkins, RDH
• Jaimie Perry
• Rachel Petchell

• Family Nurse Practitioner in Roseburg, OR
• Providers in Roseburg, OR by specialty
• Family Nurse Practitioner in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.