Individual provider Active NPI

Mark F Hutson

  • Optometrist
  • Austin, TX
National Provider Identifier
1467460550
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
02320T Issued in TX
Practice address
2415 Exposition Blvd
Suite D
Austin, TX 78703-2271
Phone
(512) 477-2282
Fax
(512) 477-2336
NPI assigned
Aug 4, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 02320T TX Primary

Addresses

Primary practice location

2415 Exposition Blvd
Suite D
Austin, TX 78703-2271

Mailing address

604 Lakeway Dr
Lakeway, TX 78734-4430
Phone (512) 261-0855

Other identifiers 1

IdentifierTypeStateIssuer
80481QOtherTXBLUE CROSS/BLUE SHIELD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
02320TTXMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Austin Vision Center Optometrist PastSince Feb 16, 1992 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1154649600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1467460550",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "604 LAKEWAY DR",
            "city": "LAKEWAY",
            "state": "TX",
            "postal_code": "787344430",
            "telephone_number": "512-261-0855"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2415 EXPOSITION BLVD",
            "address_2": "SUITE D",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787032271",
            "telephone_number": "512-477-2282",
            "fax_number": "512-477-2336"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUTSON",
        "first_name": "MARK",
        "middle_name": "F",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-04",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "02320T",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS/BLUE SHIELD",
            "identifier": "80481Q",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Austin, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 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.