Mark A Gillispie, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

8413T Issued in CA

Practice address

82227 US Highway 111
Suite B-2
Indio, CA 92201-5667

Phone

(760) 347-6636

Fax

(760) 342-5987

NPI assigned

Oct 18, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Athena Brasfield OD a Professional Corporation

  • Optometrist
  • Indio, CA
  • NPI 1821441221
  NPD (past)

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

{
    "created_epoch": "1161129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1299974400000",
    "number": "1043391899",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "82227 US HIGHWAY 111",
            "address_2": "SUITE B-2",
            "city": "INDIO",
            "state": "CA",
            "postal_code": "922015667",
            "telephone_number": "760-347-6636",
            "fax_number": "760-342-5987"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "82227 US HIGHWAY 111",
            "address_2": "SUITE B-2",
            "city": "INDIO",
            "state": "CA",
            "postal_code": "922015667",
            "telephone_number": "760-347-6636",
            "fax_number": "760-342-5987"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILLISPIE",
        "first_name": "MARK",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-18",
        "last_updated": "2011-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "8413T",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "SD0084130",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Daniel Jay Gendron, APRN-NP
• Patricia Ann Genel
• Gentle Draw Phlebotomy
• Laleh Ghaffarian
• Eduardo Cabrera Gil, RADT
• Gilman & Vorster Optometry, Inc
• Jennifer Ann Gilman Vorster, O.D.
• Michaela Gleeson
• Robert Godina
• Marta Steffanie Godoy

• Optometrist in Indio, CA
• Providers in Indio, CA by specialty
• Optometrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.