Active NPI
Kevin P. Marks, M.D.
- Pediatrics Physician
- Eugene, OR
National Provider Identifier
1164499166
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- MD23017
- Practice address
- 4010 Aerial Way
Eugene, OR 97402-9757 - Phone
- (541) 242-8500
- Fax
- (541) 242-8491
- NPI assigned
- Mar 8, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | MD23017 | OR | Primary |
Addresses
Primary practice location
4010 Aerial Way
Eugene, OR 97402-9757
Mailing address
PO Box 24410
Eugene, OR 97402
Phone (541) 984-4301
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 287635 | Medicaid | OR |
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
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD23017 | OR | MD | Pediatrics Physician |
Interoperability endpoints
- kmarks2403@direct.peacehealth.org
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1141776000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1342051200000",
"number": "1164499166",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 24410",
"city": "EUGENE",
"state": "OR",
"postal_code": "97402",
"telephone_number": "541-984-4301"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4010 AERIAL WAY",
"city": "EUGENE",
"state": "OR",
"postal_code": "974029757",
"telephone_number": "541-242-8500",
"fax_number": "541-242-8491"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARKS",
"first_name": "KEVIN",
"middle_name": "P.",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-03-08",
"last_updated": "2012-07-12",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "OR",
"license": "MD23017",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "287635",
"state": "OR"
}
],
"endpoints": [],
"other_names": []
}Other providers in Eugene, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.