Mark Louis Overson, C. PED.

Primary specialty

Other TechnicianTaxonomy code 247200000X

Practice address

6363 France Ave S
Suite 110
Edina, MN 55435-2129

Phone

(952) 929-7717

Fax

(952) 929-4535

NPI assigned

Oct 25, 2007

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1193270400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1193270400000",
    "number": "1437338589",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6363 FRANCE AVE S",
            "address_2": "SUITE 110",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554352129",
            "telephone_number": "952-929-7717",
            "fax_number": "952-929-4535"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6363 FRANCE AVE S",
            "address_2": "SUITE 110",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554352129",
            "telephone_number": "952-929-7717",
            "fax_number": "952-929-4535"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OVERSON",
        "first_name": "MARK",
        "middle_name": "LOUIS",
        "name_prefix": "Mr.",
        "credential": "C. PED.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-10-25",
        "last_updated": "2007-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "247200000X",
            "taxonomy_group": "",
            "desc": "Technician, Other",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Other Technician in Edina, MN
• Providers in Edina, MN by specialty
• Other Technician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2007; 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.