Mark a Gillispie O D Inc

Primary specialty

OptometristTaxonomy code 152W00000X

Legal business name

MARK A GILLISPIE O D INC

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

Organization subpart

No

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

Authorized official

Name

Dr. Mark A Gillispie, O.D.

Title

Owner

Phone

(760) 347-6636

Specialties & licenses 2

Addresses

Other identifiers 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Ledia Samwil, OD

  • Optometrist
  • Indio, CA
  • NPI 1043084007
  NPD (past)

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

{
    "created_epoch": "1161129600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1257206400000",
    "number": "1053492744",
    "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": {
        "organization_name": "MARK A GILLISPIE O D INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-18",
        "last_updated": "2009-11-03",
        "status": "A",
        "authorized_official_last_name": "GILLISPIE",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "760-347-6636",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GSD004740",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Guadalupe Macias Mariscal, PEER SUPPORT SPECIAL
• Amin Abed Nagiub Markos, ARDMS
• Adrine Markosyan, MD
• Marla R Lander (The Breast Health Center)
• Alexa Nicole Marquez
• Lisa Marquez

• 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 Nov 3, 2009; 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.