Mark Richard Deweese, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

OPC5030 Issued in FL

Practice address

7500 Centurion Pkwy Ste 100
Jacksonville, FL 32256-0517

Phone

(904) 443-1088

NPI assigned

Sep 1, 2015

Last updated

Jul 19, 2022By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1441065600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658188800000",
    "number": "1336516715",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7500 CENTURION PKWY STE 100",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322560517",
            "telephone_number": "904-443-1088"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7500 CENTURION PKWY STE 100",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322560517",
            "telephone_number": "904-443-1088"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEWEESE",
        "first_name": "MARK",
        "middle_name": "RICHARD",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-09-01",
        "last_updated": "2022-07-19",
        "certification_date": "2022-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC5030",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Yuneisy Devora Rodriguez
• Julie Anna Devore
• Elizabeth Devos, M.D.
• Sarah Dew-Reeves, PH.D.
• Damon Christopher Deweese, D.C.
• Daniel Campbell Dewey, MD
• Richard Bartens Dewey III, MD
• Kelly Michelle Dewit, PHARMD
• Aaron David Dewitt, D.O.
• Courtni Dexter, ARNP

• Optometrist in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Optometrist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.