Mark D Henry OD Inc

Primary specialty

OptometristTaxonomy code 152W00000X

Legal business name

MARK D HENRY OD INC

Doing business as

Primary Vision Care

Practice address

1213 N Memorial Dr
Lancaster, OH 43130-1626

Phone

(740) 654-9909

Fax

(740) 654-9969

NPI assigned

Oct 17, 2006

Organization subpart

No

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

Authorized official

Name

Amber Kennedy, LDO

Title

Optician

Phone

(740) 654-9909

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Primary Vision Care Doing business as

Medicare fee-for-service enrollment

Enrolled in OH

Enrollment records 1

Locations

Practitioners 4

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

• Courtney Irene Diaz, O.D.

  • Optometrist
  • Newark, OH
  • NPI 1760863047
  Medicare reassignment Care Compare group NPD
• Mark David Henry, OD

  • Optometrist
  • Lancaster, OH
  • NPI 1275527467
  Medicare reassignment Care Compare group NPD
• Lauren Renee Haack, O.D.

  • Optometrist
  • Dayton, OH
  • NPI 1164861860
  Medicare reassignment NPD
• John R Gwin, OD

  • Optometrist
  • Columbus, OH
  • NPI 1568542173
  NPD (past)

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

{
    "created_epoch": "1161043200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1215993600000",
    "number": "1093895690",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1213 N MEMORIAL DR",
            "city": "LANCASTER",
            "state": "OH",
            "postal_code": "431301626",
            "telephone_number": "740-654-9909",
            "fax_number": "740-654-9969"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1213 N MEMORIAL DR",
            "city": "LANCASTER",
            "state": "OH",
            "postal_code": "431301626",
            "telephone_number": "740-654-9909",
            "fax_number": "740-654-9969"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARK D HENRY OD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-17",
        "last_updated": "2008-07-14",
        "status": "A",
        "authorized_official_last_name": "KENNEDY",
        "authorized_official_first_name": "AMBER",
        "authorized_official_title_or_position": "OPTICIAN",
        "authorized_official_telephone_number": "740-654-9909",
        "authorized_official_credential": "LDO"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2455141",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Primary Vision Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Daisy Crystal Marie Marcus, LPN
• Katy Mae Marcus, CNP
• Marilyn K. Kosier, M.D., Inc.
• Marinacci Medical Laboratory Inc
• Ariel Marion
• Mark E Neff DDS, Inc
• John Michael Marque, D.D.S.
• Susan Marie Marque, MS, RD, LD
• Don Marshall
• Martin Menosky MD LLC

• Optometrist in Lancaster, OH
• Providers in Lancaster, OH by specialty
• Optometrist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.