Active NPI
Craig Matthew Marley, O.D.
- Optometrist
- Boise, ID
National Provider Identifier
1720189608
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 0-506
- Practice address
- 7319 W State St
Boise, ID 83714-6051 - Phone
- (120) 885-3478
- Fax
- (120) 885-3478
- NPI assigned
- Sep 25, 2006
- Sex
- Male
- Sole proprietor
- Yes
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 | 0-506 | ID | Primary |
Addresses
Primary practice location
7319 W State St
Boise, ID 83714-6051
Mailing address
7654 Madden Dr
Nampa, ID 83686-9425
Phone (120) 846-5658
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0-506 | ID | MD | Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159142400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1720189608",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7654 MADDEN DR",
"city": "NAMPA",
"state": "ID",
"postal_code": "836869425",
"telephone_number": "120-846-5658"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7319 W STATE ST",
"city": "BOISE",
"state": "ID",
"postal_code": "837146051",
"telephone_number": "120-885-3478",
"fax_number": "120-885-3478"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARLEY",
"first_name": "CRAIG",
"middle_name": "MATTHEW",
"name_prefix": "Dr.",
"credential": "O.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-09-25",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "ID",
"license": "0-506",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Boise, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.