Individual provider Active NPI

Mark C Ward, O.D.

  • Optometrist
  • Danville, KY
National Provider Identifier
1346233129
Registry record updated Sep 4, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1092DT Issued in KY
Practice address
359 S 4TH St
Danville, KY 40422-2078
Phone
(859) 236-3121
Fax
(859) 236-0225
NPI assigned
Aug 26, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 4, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 1092DT KY Primary

Addresses

Primary practice location

359 S 4TH St
Danville, KY 40422-2078

Mailing address

PO Box 1078
Danville, KY 40423-1078
Phone (859) 236-3121

Other identifiers 1

IdentifierTypeStateIssuer
77010924MedicaidKY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
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

Enrollment IDStateProvider typePAC IDDetails
I20060206000253 KY Practitioner - Optometry 2365456779 Practice locations: Danville, KY

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern College of Optometry, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

359 S 4TH St
Danville, KY 40422-2078
Phone (606) 236-3121

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery17

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1092DTKYMDOptometrist

NPI Registry JSON

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

{
    "created_epoch": "1125014400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1220486400000",
    "number": "1346233129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1078",
            "city": "DANVILLE",
            "state": "KY",
            "postal_code": "404231078",
            "telephone_number": "859-236-3121",
            "fax_number": "859-236-0225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "359 S 4TH ST",
            "city": "DANVILLE",
            "state": "KY",
            "postal_code": "404222078",
            "telephone_number": "859-236-3121",
            "fax_number": "859-236-0225"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WARD",
        "first_name": "MARK",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-08-26",
        "last_updated": "2008-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "KY",
            "license": "1092DT",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "77010924",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Danville, KY

Sources for this page

Verify at the official NPI Registry.