Active NPI
Mark H Stines, OD
- Optometrist
- Grand Island, NE
National Provider Identifier
1588669121
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 865
- Practice address
- 401 N Eddy St
Grand Island, NE 68801-4558 - Phone
- (308) 384-6922
- Fax
- (308) 384-7824
- NPI assigned
- Jun 20, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 865 | NE | Primary |
Addresses
Primary practice location
401 N Eddy St
Grand Island, NE 68801-4558
Mailing address
401 N Eddy St
Grand Island, NE 68801-4558
Phone (308) 384-6922
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| NE865 | Medicaid | NE |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1119225600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1278028800000",
"number": "1588669121",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "401 N EDDY ST",
"city": "GRAND ISLAND",
"state": "NE",
"postal_code": "688014558",
"telephone_number": "308-384-6922",
"fax_number": "308-384-7824"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "401 N EDDY ST",
"city": "GRAND ISLAND",
"state": "NE",
"postal_code": "688014558",
"telephone_number": "308-384-6922",
"fax_number": "308-384-7824"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STINES",
"first_name": "MARK",
"middle_name": "H",
"name_prefix": "Dr.",
"credential": "OD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-06-20",
"last_updated": "2010-07-02",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "NE",
"license": "865",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "NE865",
"state": "NE"
}
],
"endpoints": [],
"other_names": []
}Other providers in Grand Island, NE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.