Mark Allen Motley, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

OPT.003300 Issued in OH

Practice address

1355 West Main St
Bellevue, OH 44811

Phone

(419) 483-7685

Fax

(419) 483-4694

NPI assigned

Aug 16, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 5

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1155686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606953600000",
    "number": "1750494530",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1950 OLD GALLOWS RD STE 520",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221823970",
            "telephone_number": "703-847-8899",
            "fax_number": "571-223-6780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1355 WEST MAIN ST",
            "city": "BELLEVUE",
            "state": "OH",
            "postal_code": "44811",
            "telephone_number": "419-483-7685",
            "fax_number": "419-483-4694"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOTLEY",
        "first_name": "MARK",
        "middle_name": "ALLEN",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-16",
        "last_updated": "2020-12-03",
        "certification_date": "2020-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OH",
            "license": "OPT.003300",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0333704",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OHIO BWC",
            "identifier": "1750494530",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "791580458",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "00130216",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "00164996",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Hunter Missler
• Perla Monreal
• Brandi Montgomery
• Brandy Morris, FNP-C
• Seog Lae Morrison, MA, LPC
• Mark F Myers, D.D.S.
• Tabitha R Myers
• Myeyedr Optometry of Ohio, LLC
• Hannah Alyse Neibler, M.A. CF-SLP
• Aaron Graves Nicely, D.C.

• Optometrist in Bellevue, OH
• Providers in Bellevue, OH by specialty
• Optometrist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2020; 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.