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DR. MARK LOWELL HIGDON D.O.
NPI 1598857187
Family Medicine in Cornelius, NC

Active since September 29, 2006PECOS EnrolledAccepts Medicare Assignment
19485 OLD JETTON RD STE 100, CORNELIUS, NC 28031(704) 316-5170(704) 316-5172 Get Directions Write a Review

NPPES record last updated: October 25, 2020. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Oct 25, 2020, Nov 15, 2016 (2 updates tracked since 2016).

About Dr. Mark Lowell Higdon D.o. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. MARK LOWELL HIGDON D.O. (NPI 1598857187) is an individual family medicine provider in Cornelius, North Carolina, licensed in North Carolina (2014-01893) and active in the NPI registry since September 2006. He is enrolled in Medicare PECOS and is a graduate of West Virginia School Of Osteopathic Medicine (1996).

NPPES Registry Identity

NPI1598857187
Entity TypeIndividualMale
Primary Taxonomy207Q00000X
Provider Legal NameDR. MARK LOWELL HIGDONCredential: D.O.
Location Address19485 OLD JETTON RD STE 100Cornelius, NC 28031-6583
Mailing AddressPo Box 60447Charlotte, NC 28260-0447 · (704) 316-5170 · Fax (704) 316-5172
Phone(704) 316-5170
Fax(704) 316-5172
Sole ProprietorNo
Medical School CMSWest Virginia School Of Osteopathic MedicineGraduated 1996
Enumeration DateSeptember 29, 2006
Last NPPES UpdateOctober 25, 20202 updates tracked since enumeration
NPPES CertifiedSeptember 25, 2020
✔ NPI 1598857187 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
Licenses✔ Licensed in NC · 2014-01893✔ Licensed in GA · 044938
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
19485 OLD JETTON RD STE 100, Cornelius, NC 28031
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Other Identifiers 1

Medicaid1598857187NC

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of NC.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Mark Lowell Higdon D.o. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID3678754231
PECOS Enrollment IDI20151023001673
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 6

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
46 services38 patients
Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
32 services26 patients
Administration of influenza virus vaccine G0008
The administration of the influenza virus vaccine, also known as the flu shot, is a simple procedure to protect against the flu. A healthcare provider injects a small dose of the vaccine into your arm. This stimulates your immune system to produce antibodies, which will help your body fight off the flu if exposed.
24 services24 patients
Influenza vaccine, inactivated 90653
The Influenza vaccine, inactivated, is a shot given to protect against the flu. It contains killed virus particles that help your body build immunity to the flu. It's recommended annually to keep your protection up-to-date. It's safe for ages 6 months and up.
23 services23 patients
Hemoglobin a1c level 83036
Hemoglobin A1c (HbA1c) is a test that measures your average blood sugar level over the past 2-3 months. It's used to monitor how well diabetes is being controlled. High levels may indicate that your diabetes treatment plan needs adjustment.
20 services18 patients
Manual urinalysis test with examination using microscope, automated 81001
A manual urinalysis test with automated microscopic examination is a lab process that checks your urine for health indicators. It involves a machine scanning your sample to identify any abnormal elements, which can assist in diagnosing various conditions.
18 services15 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 28031 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$83.90 typical visit price
range $54.12 – $165.09
Typical copayment $20.97 (range $13.53 – $41.27)
Most-billed visit code 99203
Established Patient
$95.94 typical visit price
range $17.21 – $134.61
Typical copayment $23.98 (range $4.30 – $33.65)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. GERARDO PEREZ DO
Student in an Organized Health Care Education/Training Program
19485 OLD JETTON RD STE 100
CORNELIUS, NC 28031
Mecklenburg County (704) 316-5170
DR. RACHEL ANNE LATTERICH DO
Student in an Organized Health Care Education/Training Program
19485 OLD JETTON RD STE 100
CORNELIUS, NC 28031
Mecklenburg County (704) 316-5170
MICHAELA LYNNE ROBERTS MD
Family Medicine
19485 OLD JETTON RD STE 100
CORNELIUS, NC 28031
Mecklenburg County (704) 384-1775
DEVON VARNEY DO
Student in an Organized Health Care Education/Training Program
19485 OLD JETTON RD STE 100
CORNELIUS, NC 28031
Mecklenburg County (704) 316-5170
JYOTHI PRAVALLIKA EDUPUGANTI DO
Student in an Organized Health Care Education/Training Program
19485 OLD JETTON RD STE 100
CORNELIUS, NC 28031
Mecklenburg County (704) 316-5170
JAMIE DYVIG CREWS
Student in an Organized Health Care Education/Training Program
19485 OLD JETTON RD STE 100
CORNELIUS, NC 28031
Mecklenburg County (704) 316-5170
DR. PUJA DALAL
Family Medicine
19485 OLD JETTON RD STE 100
CORNELIUS, NC 28031
Mecklenburg County (704) 316-5170
NOVANT HEALTH MEDICAL GROUP, LLC
Family Medicine
19485 OLD JETTON RD STE 100
CORNELIUS, NC 28031
Mecklenburg County (704) 384-1775

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Mark Higdon's NPI number?

The NPI number for Mark Higdon is 1598857187. It was assigned to this individual provider in the NPPES registry on September 29, 2006.

Where is Mark Higdon located?

Mark Higdon practices at 19485 Old Jetton Rd Ste 100, Cornelius, NC 28031. The listed phone number is (704) 316-5170.

What is Mark Higdon's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Mark Higdon enrolled in Medicare?

Yes. Mark Higdon is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Mark Higdon accept?

Health plans from Blue Cross and Blue Shield of NC list Mark Higdon as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Mark Higdon was last updated on October 25, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.