Individual provider Active NPI

Mark Richard Esham, ARNP

  • Nurse Practitioner
  • Davenport, FL
National Provider Identifier
1891754545
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
ARNP3077032 Issued in FL
Practice address
40100 Highway 27
Davenport, FL 33837
Phone
(863) 422-4971
NPI assigned
Mar 21, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X ARNP3077032 FL Primary

Addresses

Primary practice location

40100 Highway 27
Davenport, FL 33837

Mailing address

8390 Champions Gate Blvd
Ste 306
Champions Gate, FL 33896
Phone (407) 390-1677

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20040205000659 FL Practitioner - Nurse Practitioner 2264325091 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ridgewood Emergency Group, LLCGroup PAC ID 6305199597, 43 clinicians

Practice addresses (Care Compare)

40100 Hwy 27
Davenport, FL 33837-5906
Phone (863) 422-4971

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Ridgewood Emergency Group, LLC Nurse Practitioner CurrentSince Nov 1, 2018 Accepting new patients
Ridgewood Emergency Group, LLC Nurse Practitioner CurrentSince Nov 1, 2018 Accepting new patients
Lake Wales Emergency Physicians, LLC Nurse Practitioner Past Accepting new patients
Advance Technological Radiology, PA Past Accepting new patients

Locations

40100 Highway 27
Davenport, FL 33837
Phone (863) 419-2496

Organizations & group practices 4

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1142899200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1891754545",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8390 CHAMPIONS GATE BLVD",
            "address_2": "STE 306",
            "city": "CHAMPIONS GATE",
            "state": "FL",
            "postal_code": "33896",
            "telephone_number": "407-390-1677",
            "fax_number": "407-390-1765"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40100 HIGHWAY 27",
            "city": "DAVENPORT",
            "state": "FL",
            "postal_code": "33837",
            "telephone_number": "863-422-4971"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ESHAM",
        "first_name": "MARK",
        "middle_name": "RICHARD",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-21",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "ARNP3077032",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Davenport, FL

Sources for this page

Verify at the official NPI Registry.