Individual provider Active NPI

Marcus Jones

  • Optician
  • Austin, TX
National Provider Identifier
1740438662
Registry record updated Sep 4, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OpticianTaxonomy code 156FX1800X
License
263146320 Issued in TX
Practice address
5811 Berkman Dr
121
Austin, TX 78723-2666
Phone
(512) 926-2400
Fax
(512) 926-2608
NPI assigned
Sep 4, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 4, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optician 156FX1800X 263146320 TX Primary

Addresses

Primary practice location

5811 Berkman Dr
121
Austin, TX 78723-2666

Mailing address

5811 Berkman Dr
121
Austin, TX 78723-2666
Phone (512) 926-2400

Other names 1

  • Ideal Optical Professional name

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

LicenseStateTypeSpecialty
263146320TXMDOptician

NPI Registry JSON

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

{
    "created_epoch": "1220486400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1220486400000",
    "number": "1740438662",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5811 BERKMAN DR",
            "address_2": "121",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787232666",
            "telephone_number": "512-926-2400",
            "fax_number": "512-926-2608"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5811 BERKMAN DR",
            "address_2": "121",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787232666",
            "telephone_number": "512-926-2400",
            "fax_number": "512-926-2608"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JONES",
        "first_name": "MARCUS",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-09-04",
        "last_updated": "2008-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "156FX1800X",
            "taxonomy_group": "",
            "desc": "Technician/Technologist, Optician",
            "state": "TX",
            "license": "263146320",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "IDEAL",
            "last_name": "OPTICAL",
            "credential": "IDEAL OPTICAL",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

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 Sep 4, 2008; 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.