Individual provider Active NPI

Marcus Donn Morben, O.D.

  • Optometrist
  • Woodbury, MN
National Provider Identifier
1184774614
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2260 Issued in MN
Practice address
8362 Tamarack VLG
#108
Woodbury, MN 55125-3392
Phone
(651) 730-9662
NPI assigned
Jan 10, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2260 MN Primary

Addresses

Primary practice location

8362 Tamarack VLG
#108
Woodbury, MN 55125-3392

Mailing address

904 Spring Hill Draw
Woodbury, MN 55125-8614
Phone (651) 730-4086

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
Flagged The directory lists this NPI on an HHS exclusion list. 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
2260MNMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Luxottica of America Inc Past Accepting new patients
Luxottica of America Inc. Past Accepting new patients
Visionworks Inc Past Accepting new patients
Vision World Inc Past Accepting new patients
Vision World Inc Past Accepting new patients

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1168387200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1184774614",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "904 SPRING HILL DRAW",
            "city": "WOODBURY",
            "state": "MN",
            "postal_code": "551258614",
            "telephone_number": "651-730-4086",
            "fax_number": "651-730-1888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8362 TAMARACK VLG",
            "address_2": "#108",
            "city": "WOODBURY",
            "state": "MN",
            "postal_code": "551253392",
            "telephone_number": "651-730-9662"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORBEN",
        "first_name": "MARCUS",
        "middle_name": "DONN",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-10",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MN",
            "license": "2260",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodbury, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.