H. Scott Mortensen III, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

ODP-0654 Issued in ID

Practice address

49 E 1St S
Rexburg, ID 83440-1966

Phone

(208) 356-4444

Fax

(208) 356-4445

NPI assigned

Jun 22, 2006

Last updated

Aug 26, 2008By 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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1150934400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1219708800000",
    "number": "1346286549",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "49 E 1ST S",
            "address_2": "PO BOX 577",
            "city": "REXBURG",
            "state": "ID",
            "postal_code": "834401966",
            "telephone_number": "208-356-4444",
            "fax_number": "208-356-4445"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "49 E 1ST S",
            "city": "REXBURG",
            "state": "ID",
            "postal_code": "834401966",
            "telephone_number": "208-356-4444",
            "fax_number": "208-356-4445"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORTENSEN",
        "first_name": "H.",
        "middle_name": "SCOTT",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-22",
        "last_updated": "2008-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "ID",
            "license": "ODP-0654",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "002488500",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Hannah Mora
• Lindsey J Morey
• James Morris, MD
• Susan Olivia Morris, LMSW
• Damon Scott Mortensen, OD
• Nathan Cody Mortensen, OD
• Stephen Gary Moss, PHARM.D.
• Mountain Health and Wellness
• Mountain Valley Imaging LLC
• Mountain View Hospital LLC

• Optometrist in Rexburg, ID
• Providers in Rexburg, ID by specialty
• Optometrist in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2008; 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.