MARK RANDALL SEXTON MD
NPI 1982678702
Family Medicine in Columbus, GA

Active since February 16, 2006PECOS EnrolledAccepts Medicare Assignment
91.65/100
CMS Quality Rating
6801 RIVER RD, STE 101, COLUMBUS, GA 31904(706) 494-0694(706) 494-0695 Get Directions Write a Review

NPPES record last updated: June 3, 2015. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Mark Randall Sexton Md NPPES

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

MARK RANDALL SEXTON MD (NPI 1982678702) is an individual family medicine provider in Columbus, Georgia, licensed in Georgia (039934) and active in the NPI registry since February 2006. He is enrolled in Medicare PECOS, is affiliated with Piedmont Columbus Regional Midtown, and is a graduate of Other (1988).

NPPES Registry Identity

NPI1982678702
Entity TypeIndividualMale
Primary Taxonomy207Q00000X
Provider Legal NameMARK RANDALL SEXTONCredential: MD
Location Address6801 RIVER RD, STE 101Columbus, GA 31904-3352
Mailing Address6801 River Rd, Ste 101Columbus, GA 31904-3352 · (706) 494-0694 · Fax (706) 494-0695
Fax(706) 494-0695
Sole ProprietorNo
Medical School CMSOtherGraduated 1988
Enumeration DateFebruary 16, 2006
Last NPPES UpdateJune 3, 2015
NPI 1982678702 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License Licensed in GA · 039934
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.

6801 RIVER RD, Columbus, GA 31904

Accepted 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

Mark Randall Sexton Md 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 ID1052449139
PECOS Enrollment IDI20100511000554
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 7

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.
520 services197 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.
166 services58 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.
65 services58 patients
Injection of drug or substance under skin or into muscle 96372
This procedure involves administering medication directly under the skin or into a muscle. A small needle is used to inject the drug, allowing it to be absorbed quickly into the bloodstream. It's a common method for delivering a variety of medications.
62 services13 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.
52 services52 patients
Influenza vaccine split virus, preservative free 90662
The Influenza Vaccine Split Virus, preservative-free, is a flu shot to protect against the influenza virus. It is made from parts of inactivated flu viruses and doesn't contain preservatives, reducing potential side effects. It helps your body develop immunity to the flu.
51 services51 patients

Hospital Affiliations CMS Care Compare 2

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Piedmont Columbus Regional Midtown

Acute Care Hospitals · Columbus, GA
2/5 CMS rating
OwnershipVoluntary non-profit - Other
CMS Certification Number110064
Location710 Center StreetColumbus, GA 31901 · Muscogee County
Emergency services Birthing friendly

St Francis Hospital- Emory Healthcare

Acute Care Hospitals · Columbus, GA
2/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number110129
Location2122 Manchester ExpresswayColumbus, GA 31995 · Muscogee County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 31904 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
$83.23 typical visit price
range $53.31 – $164.04
Typical copayment $20.80 (range $13.32 – $41.01)
Most-billed visit code 99203
Established Patient
$94.84 typical visit price
range $16.68 – $133.24
Typical copayment $23.71 (range $4.17 – $33.31)
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.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

91.65/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Promoting Interoperability99
Improvement Activities20

Referred Medical Equipment & Supplies CMS DME claims 13

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253
DME-Other DME · category DE017N
6 suppliers19 claims31 services$6.60 avg. paid by Medicare
Lubricant, individual sterile packet, each A4332
DME-Medical/Surgical Supplies · category DA000N
1 supplier12 claims1,440 services$0.10 avg. paid by Medicare
Intermittent urinary catheter; straight tip, with or without coating (teflon, silicone, silicone elastomer, or hydrophilic, etc.), each A4351
DME-Orthotic Devices · category DF008N
2 suppliers19 claims2,070 services$1.66 avg. paid by Medicare
Full face mask used with positive airway pressure device, each A7030
DME-Other DME · category DE001N
3 suppliers14 claims14 services$90.41 avg. paid by Medicare
Face mask interface, replacement for full face mask, each A7031
DME-Other DME · category DE001N
2 suppliers13 claims39 services$36.03 avg. paid by Medicare
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap A7034
DME-Other DME · category DE001N
3 suppliers13 claims13 services$59.33 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 9

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

Clinic/Center (Health Service)
6801 RIVER RD, SUITE 106
COLUMBUS, GA 31904
Dentist (General Practice)
6801 RIVER RD, BUILDING A, SUITE 200
COLUMBUS, GA 31904
Nurse Practitioner (Family)
6801 RIVER RD, SUITE 101
COLUMBUS, GA 31904
Family Medicine
6801 RIVER RD, STE 301
COLUMBUS, GA 31904
Physical Therapist
6801 RIVER RD, STE 302
COLUMBUS, GA 31904
Nurse Practitioner (Family)
6801 RIVER RD, SUITE 106
COLUMBUS, GA 31904
Dentist (General Practice)
6801 RIVER RD, BUILDING A, SUITE 200
COLUMBUS, GA 31904
Dentist (Pediatric Dentistry)
6801 RIVER RD, BUILDING 4, SUITE 401
COLUMBUS, GA 31904

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 Sexton's NPI number?

The NPI number for Mark Sexton is 1982678702. It was assigned to this individual provider in the NPPES registry on February 16, 2006.

Where is Mark Sexton located?

Mark Sexton practices at 6801 River Rd Ste 101, Columbus, GA 31904. The listed phone number is (706) 494-0694.

What is Mark Sexton's specialty?

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

Is Mark Sexton enrolled in Medicare?

Yes. Mark Sexton 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 Sexton accept?

Health plans from Alliant Health Plans, Inc., Ambetter Health, Ambetter from Absolute Total Care, Ambetter of Alabama and Ambetter of North Carolina and 2 other insurers list Mark Sexton 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.

Is Mark Sexton affiliated with any hospitals?

According to CMS data, Mark Sexton is affiliated with Piedmont Columbus Regional Midtown and St Francis Hospital- Emory Healthcare.

When was this NPI record last updated?

The NPPES record for Mark Sexton was last updated on June 3, 2015. NPI Profile syncs with the weekly NPPES data releases published by CMS.