Organization Active NPI

John R. Markham PC

Doing business as Prescott Vision & Eye Surgery Center

  • Eyewear Supplier
  • Chino Valley, AZ
National Provider Identifier
1104090737
Registry record updated Jul 1, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Eyewear SupplierTaxonomy code 332H00000X
Legal business name
JOHN R. MARKHAM PC
Doing business as
Prescott Vision & Eye Surgery Center
Practice address
399 Palomino Road
Chino Valley, AZ 86323
Phone
(928) 636-5504
Fax
(928) 636-0780
NPI assigned
Apr 15, 2008
Last updated
Jul 1, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2008

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

Authorized official

Name
Dr. Scott Markham, DONPI 1972688836
Title
Medical Director
Phone
(928) 778-3950

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Eyewear Supplier 332H00000X AZ Primary

Addresses

Primary practice location

399 Palomino Road
Chino Valley, AZ 86323

Mailing address

1680 Willow Creek Rd
Prescott, AZ 86301
Phone (928) 778-3950

Other identifiers 7

IdentifierTypeStateIssuer
033176MedicaidAZ
866291-9714OtherHUMANA
AZ01170OtherMEDICARE SUBMITTER ID - PRESCOTT
15220OtherAVESIS
5858351OtherAETNA
0384690001OtherDMERC OPTICAL SUPPLIER - PRESCOTT
190721MedicaidAZ

Other names 1

  • Prescott Vision & Eye Surgery Center Doing business as

National Provider Directory

National Provider Directory
Tax ID family
John R Markham PC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Locations

399 W Palomino Rd
Chino Valley, AZ 86323
Phone (928) 636-5504

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1208217600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1214870400000",
    "number": "1104090737",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1680 WILLOW CREEK RD",
            "city": "PRESCOTT",
            "state": "AZ",
            "postal_code": "86301",
            "telephone_number": "928-778-3950",
            "fax_number": "928-778-3999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "399 PALOMINO ROAD",
            "city": "CHINO VALLEY",
            "state": "AZ",
            "postal_code": "86323",
            "telephone_number": "928-636-5504",
            "fax_number": "928-636-0780"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOHN R. MARKHAM PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-15",
        "last_updated": "2008-07-01",
        "status": "A",
        "authorized_official_last_name": "MARKHAM",
        "authorized_official_first_name": "SCOTT",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "928-778-3950",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": "AZ",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "033176",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HUMANA",
            "identifier": "866291-9714",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE SUBMITTER ID - PRESCOTT",
            "identifier": "AZ01170",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AVESIS",
            "identifier": "15220",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "5858351",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DMERC OPTICAL SUPPLIER - PRESCOTT",
            "identifier": "0384690001",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "190721",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Prescott Vision & Eye Surgery Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Chino Valley, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2008; 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.