NPIMap

Organization Active NPI

Mark R. Barker, O.D.P.C.

  • Optometrist
  • Bonners Ferry, ID
National Provider Identifier
1154660041
Registry record updated Feb 12, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
ODD-541 Issued in ID
Legal business name
MARK R. BARKER, O.D.P.C.
Practice address
7177 Main St.
Bonners Ferry, ID 83805
Phone
(208) 267-2020
Fax
(208) 267-8813
NPI assigned
Feb 12, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 12, 2013

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

Authorized official

Name
Dr. Mark Ree Barker, O.D.
Title
Sole Owner
Phone
(208) 267-2020

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X ODD-541 ID Primary

Addresses

Primary practice location

7177 Main St.
Bonners Ferry, ID 83805

Mailing address

P. O. Box U
Bonners Ferry, ID 83805
Phone (208) 267-2020

Other identifiers 1

IdentifierTypeStateIssuer
001963000MedicaidID

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1360627200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1360627200000",
    "number": "1154660041",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P. O. BOX U",
            "city": "BONNERS FERRY",
            "state": "ID",
            "postal_code": "83805",
            "telephone_number": "208-267-2020",
            "fax_number": "208-267-8813"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7177 MAIN ST.",
            "city": "BONNERS FERRY",
            "state": "ID",
            "postal_code": "83805",
            "telephone_number": "208-267-2020",
            "fax_number": "208-267-8813"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARK R. BARKER, O.D.P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-02-12",
        "last_updated": "2013-02-12",
        "status": "A",
        "authorized_official_last_name": "BARKER",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "REE",
        "authorized_official_title_or_position": "SOLE OWNER",
        "authorized_official_telephone_number": "208-267-2020",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "ID",
            "license": "ODD-541",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001963000",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bonners Ferry, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2013; 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.