Individual provider Active NPI

Mary Ann Marston, OD

  • Optometrist
  • Knoxville, TN
National Provider Identifier
1073677001
Registry record updated Jan 18, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1291 Issued in TN
Practice address
7550 Norris Fwy
Knoxville, TN 37938-4221
Phone
(865) 925-2020
Fax
(865) 925-2020
NPI assigned
Dec 21, 2006
Last updated
Jan 18, 2011By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 18, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 1291 TN Primary

Addresses

Primary practice location

7550 Norris Fwy
Knoxville, TN 37938-4221

Mailing address

7550 Norris Fwy
Knoxville, TN 37938-4221
Phone (865) 925-2020

Other identifiers 1

IdentifierTypeStateIssuer
3597477MedicaidTN

Other names 1

  • Mary Ann Eubank Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

State licenses

LicenseStateTypeSpecialty
1291TNMDOptometrist

NPI Registry JSON

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

{
    "created_epoch": "1166659200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1295308800000",
    "number": "1073677001",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7550 NORRIS FWY",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379384221",
            "telephone_number": "865-925-2020",
            "fax_number": "865-925-2020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7550 NORRIS FWY",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379384221",
            "telephone_number": "865-925-2020",
            "fax_number": "865-925-2020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARSTON",
        "first_name": "MARY",
        "middle_name": "ANN",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-21",
        "last_updated": "2011-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TN",
            "license": "1291",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3597477",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARY",
            "last_name": "EUBANK",
            "middle_name": "ANN",
            "credential": "OD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Knoxville, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 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.