Fourone2020 PLLC

Primary specialty

OptometristTaxonomy code 152W00000X

License

2557 Issued in MN

Legal business name

FOURONE2020 PLLC

Doing business as

DBA Greg B Markeson OD

Practice address

1750 Robert St S
West St Paul, MN 55118-3919

Phone

(651) 306-0412

Fax

(651) 306-0414

NPI assigned

Jul 27, 2018

Organization subpart

No

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

Authorized official

Name

Greg B Markeson, ODNPI 1205917473

Title

Owner/Optometrist

Phone

(612) 812-4691

Specialties & licenses 1

Addresses

Other names 1

• DBA Greg B Markeson OD Doing business as

Medicare fee-for-service enrollment

Enrolled in MN

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Greg B Markeson, OD

  • Optometrist
  • West St Paul, MN
  • NPI 1205917473
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1532649600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1540339200000",
    "number": "1538646930",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11146 SWEETWATER PATH",
            "city": "WOODBURY",
            "state": "MN",
            "postal_code": "551295293",
            "telephone_number": "612-812-4691"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1750 ROBERT ST S",
            "city": "WEST ST PAUL",
            "state": "MN",
            "postal_code": "551183919",
            "telephone_number": "651-306-0412",
            "fax_number": "651-306-0414"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOURONE2020 PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-07-27",
        "last_updated": "2018-10-24",
        "status": "A",
        "authorized_official_last_name": "MARKESON",
        "authorized_official_first_name": "GREG",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "OWNER/OPTOMETRIST",
        "authorized_official_telephone_number": "612-812-4691",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "MN",
            "license": "2557",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "DBA Greg B Markeson OD",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Raymond John Fabian Jr., PTA
• Family Healthservices Minnesota, P.a. (FHSM - Gorman Clinic)
• Family Healthservices Minnesota, P.a. (Entira Family Clinics-West St. Paul)
• Vivian Fischer, MD
• Laura L Flockencier, O.D.
• Kathleen Ann Fox, OTR/L
• Garrity Optimum Health PA (MSK Chiropractic)
• Brian Scott Garrity, DC, RVT
• Garza Therapeutic, LLC
• Sean Geary, D.M.D.

• Optometrist in West St Paul, MN
• Providers in West St Paul, MN by specialty
• Optometrist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.