Obermark Optometry, Inc

Primary specialty

OptometristTaxonomy code 152W00000X

Legal business name

OBERMARK OPTOMETRY, INC

Practice address

222 W Main St
Washington, MO 63090-2154

Phone

(636) 239-7144

Fax

(636) 239-6266

NPI assigned

Jan 23, 2008

Organization subpart

No

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

Authorized official

Name

Ms. Rebecca Mitchell Obermark, RN, BSN, ABOC

Title

Officer / Manager

Phone

(636) 239-7144

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in MO

Enrollment records 1

Locations

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

• Obermark Optometry, Inc.

  • Optometrist
  • Belle, MO
  • NPI 1619145794
  NPPES parent name

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Edward Omer Obermark, O.D.

  • Optometrist
  • Washington, MO
  • NPI 1720019375
  Medicare reassignment NPD

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

{
    "created_epoch": "1201046400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208649600000",
    "number": "1275710014",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "222 W MAIN ST",
            "city": "WASHINGTON",
            "state": "MO",
            "postal_code": "630902154",
            "telephone_number": "636-239-7144",
            "fax_number": "636-239-6266"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "222 W MAIN ST",
            "city": "WASHINGTON",
            "state": "MO",
            "postal_code": "630902154",
            "telephone_number": "636-239-7144",
            "fax_number": "636-239-6266"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OBERMARK OPTOMETRY, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-23",
        "last_updated": "2008-04-20",
        "status": "A",
        "authorized_official_last_name": "OBERMARK",
        "authorized_official_first_name": "REBECCA",
        "authorized_official_middle_name": "MITCHELL",
        "authorized_official_title_or_position": "OFFICER / MANAGER",
        "authorized_official_telephone_number": "636-239-7144",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "RN, BSN, ABOC"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "317927903",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHCARE USA",
            "identifier": "4195 X 1285",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jennifer Faye Noelker, PT
• Charles Upshur Nottingham, MD
• Julie Ann Novak-Eversole
• Nu-Crown, LLC
• Megan Nicole Oberg, CPM
• Edward Omer Obermark, O.D.
• Melissa Ann Ohm, DPT
• Kelly Anne Oreskovic, LCSW
• Kyle Fritz Ostrom, M.D.
• Amanda Anne Oswalt, FNP-BC

• Optometrist in Washington, MO
• Providers in Washington, MO by specialty
• Optometrist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2008; 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.