Dr. Daniel R. Obermark Optometry PC

Primary specialty

OptometristTaxonomy code 152W00000X

License

TO2935 Issued in MO

Legal business name

DR. DANIEL R. OBERMARK OPTOMETRY PC

Practice address

1909 N. Westwood Blvd.
Poplar Bluff, MO 63901-2807

Phone

(573) 785-6717

Fax

(573) 785-3561

NPI assigned

Mar 13, 2008

Last updated

Oct 25, 2012By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Daniel Robert Obermark, O.D.NPI 1194709220

Title

Optometrist

Phone

(573) 471-1080

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MO

Enrollment records 1

Locations

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.

• Daniel Robert Obermark, O.D.

  • Optometrist
  • Sikeston, MO
  • NPI 1194709220
  Medicare reassignment Care Compare group Authorized official
• Cassidy Obermark, O.D.

  • Optometrist
  • Sikeston, MO
  • NPI 1841546074
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1205366400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1351123200000",
    "number": "1205007614",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 709",
            "city": "SIKESTON",
            "state": "MO",
            "postal_code": "638010709",
            "telephone_number": "573-471-1080",
            "fax_number": "573-471-1810"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1909 N. WESTWOOD BLVD.",
            "city": "POPLAR BLUFF",
            "state": "MO",
            "postal_code": "639012807",
            "telephone_number": "573-785-6717",
            "fax_number": "573-785-3561"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR. DANIEL R. OBERMARK OPTOMETRY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-13",
        "last_updated": "2012-10-25",
        "status": "A",
        "authorized_official_last_name": "OBERMARK",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_middle_name": "ROBERT",
        "authorized_official_title_or_position": "OPTOMETRIST",
        "authorized_official_telephone_number": "573-471-1080",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MO",
            "license": "TO2935",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "318104809",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Katrina L. Dowell, LCSW
• Kayla Dowell, PHARMD
• Britney Deshay Downs, OT
• Dr Jerry W Long Optometry
• Dr John N Fox DDS Ms PC
• Dr. Michael R. Penney Optometrist PC
• Richard Eugene Draper, DO
• Drjerry W Long Optometry
• Gina L Duckett, LPC, NCC
• Tasheka Shaconnie Dudley

• Optometrist in Poplar Bluff, MO
• Providers in Poplar Bluff, MO by specialty
• Optometrist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2012; 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.