Active NPI
Mark R Zilm, OD
- Optometrist
- Glenwood Springs, CO
National Provider Identifier
1043204480
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 1150
- Practice address
- 3122 Blake Ave
Glenwood Springs, CO 81601-4415 - Phone
- (970) 945-2020
- Fax
- (970) 945-5630
- NPI assigned
- Aug 31, 2005
- Last updated
- Sep 9, 2011
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 1150 | CO | Primary |
Addresses
Primary practice location
3122 Blake Ave
Glenwood Springs, CO 81601-4415
Mailing address
3122 Blake Ave
Glenwood Springs, CO 81601-4415
Phone (970) 945-2020
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 08115008 | Medicaid | CO |
Other names 1
- Dr. Mark R Zilm
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CO
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1150 | CO | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| 2020 Eye Care PLLC | Optometrist | Current | Accepting new patients |
| 2020 Eye Care PLLC | Optometrist | Current | Accepting new patients |
Locations
3122 Blake Ave
Glenwood Springs, CO 81601
Phone (970) 945-2020
Organizations & group practices 2
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1125446400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1315526400000",
"number": "1043204480",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3122 BLAKE AVE",
"city": "GLENWOOD SPRINGS",
"state": "CO",
"postal_code": "816014415",
"telephone_number": "970-945-2020",
"fax_number": "970-945-5630"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3122 BLAKE AVE",
"city": "GLENWOOD SPRINGS",
"state": "CO",
"postal_code": "816014415",
"telephone_number": "970-945-2020",
"fax_number": "970-945-5630"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ZILM",
"first_name": "MARK",
"middle_name": "R",
"name_prefix": "Dr.",
"credential": "OD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-08-31",
"last_updated": "2011-09-09",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "CO",
"license": "1150",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "08115008",
"state": "CO"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "MARK",
"last_name": "ZILM",
"middle_name": "R",
"prefix": "DR.",
"credential": "DR OF OPTOMETRY",
"code": "2",
"type": "Professional Name"
}
]
}Other providers in Glenwood Springs, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2011; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.