Look up the most recent NPI and PECOS records

Mark Elliott Mcdaniel

Family Medicine

Allopathic & Osteopathic Physicians

(866) 233-1955 (304) 399-4405

PECOS Enrollment

This provider is enrolled in PECOS as MARK MCDANIEL.

Based on the most recent information from CMS, provider Mark Elliott Mcdaniel is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records 8 days ago.

Profile Details

Provider ID
1134230311
Provider Type
Individual
Full Name
Mcdaniel, Mark Elliott
Credential
D.O.

Gender
Male
Sole Proprietor
Yes
Enumeration Date
8/31/2006
Last Updated
2/28/2025

Contact Information

Practice Location

201 22nd St, Ashland, KY 41101-7803

(866) 233-1955

(304) 523-7738

Mailing Location

PO Box 4190, Barboursville, WV 25504-4190

(304) 399-4405

(304) 399-2526

Provider Taxonomies

Code	Description	License
Code 207Q00000X Primary	Description Family Medicine Allopathic & Osteopathic Physicians	License 1980 West Virginia
Code 207Q00000X	Description Family Medicine Allopathic & Osteopathic Physicians	License OS10096 Florida
Code 207Q00000X	Description Family Medicine Allopathic & Osteopathic Physicians	License 34.010454 Ohio
Code 207Q00000X	Description Family Medicine Allopathic & Osteopathic Physicians	License 2012-01177 North Carolina

Provider Identifiers

ID	Description	Issuer
ID 2004366000	Description Medicaid	Issuer Unlisted Ohio
ID P01135827	Description Other	Issuer MEDICARE RAILROAD - MHCPI Ohio
ID 0066990	Description Medicaid	Issuer Unlisted Ohio
ID P00609571	Description Other	Issuer MCR RR Florida
ID 30257	Description Medicaid	Issuer Unlisted Florida

Mark Elliott Mcdaniel

PECOS Enrollment

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