Individual provider Active NPI

Mark McMurray, O.D.

  • Optometrist
  • Niles, OH
National Provider Identifier
1508946542
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
4766T1570 Issued in OH
Practice address
1040 Youngstown Warren Rd
Niles, OH 44446-4617
Phone
(330) 544-9434
Fax
(330) 544-9433
NPI assigned
Oct 16, 2006
Sex
Male
Sole proprietor
No

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 4766T1570 OH Primary

Addresses

Primary practice location

1040 Youngstown Warren Rd
Niles, OH 44446-4617

Mailing address

801 Thornberry TRL
North Lima, OH 44452-8518
Phone (330) 549-5696

Other identifiers 1

IdentifierTypeStateIssuer
2002371MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20150924003171 OH Practitioner - Optometry 9830107549 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4766T1570OHMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Dr. Ronald L. Detwiler, O.D. Inc. Optometrist CurrentSince May 18, 2016 Accepting new patients
Mobile Medical, Inc. CurrentSince Jul 12, 2016 Accepting new patients
Mobile Medical Inc Optometrist CurrentSince Jul 12, 2016 Accepting new patients
Onsight Health Care, LLC Past Accepting new patients
Suburban Vision Care, Inc. Optometrist Past Accepting new patients
Mobile Medical, Inc. Past Accepting new patients
Optical Management Systems, Inc. Optometrist Past Accepting new patients

Locations

575 White Pond Dr
Ste A
Akron, OH 44320
Phone (330) 835-1629

15655 State Route 170
Ste P
East Liverpool, OH 43920
Phone (330) 385-3895

3255 Levis Commons Blvd
Perrysburg, OH 43551
Phone (419) 874-0393

102 N Keel Ridge Rd
Hermitage, PA 16148
Phone (724) 347-0591

Organizations & group practices 7

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": "1160956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1508946542",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 THORNBERRY TRL",
            "city": "NORTH LIMA",
            "state": "OH",
            "postal_code": "444528518",
            "telephone_number": "330-549-5696"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1040 YOUNGSTOWN WARREN RD",
            "city": "NILES",
            "state": "OH",
            "postal_code": "444464617",
            "telephone_number": "330-544-9434",
            "fax_number": "330-544-9433"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCMURRAY",
        "first_name": "MARK",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-16",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OH",
            "license": "4766T1570",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2002371",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Niles, OH

Sources for this page

Verify at the official NPI Registry.