Dr Mark D Denney OD PA

Primary specialty

OptometristTaxonomy code 152W00000X

License

ODP1012 Issued in ID

Legal business name

DR MARK D DENNEY OD PA

Practice address

1340 S. Ammon Road
Idaho Falls, ID 83406

Phone

(208) 523-3141

Fax

(208) 525-2661

NPI assigned

May 15, 2007

Last updated

Jun 21, 2018By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mark D Denney, ODNPI 1962569681

Title

Optometrist

Phone

(208) 523-3141

Specialties & licenses 1

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in ID

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Mark D Denney, OD

  • Optometrist
  • Ammon, ID
  • NPI 1962569681
  Medicare reassignment NPD Authorized official
• David Bryan Cook, O.D.

  • Optometrist
  • Idaho Falls, ID
  • NPI 1912074741
  NPD (past)

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

{
    "created_epoch": "1179187200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1529539200000",
    "number": "1780890541",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1340 S AMMON RD",
            "city": "AMMON",
            "state": "ID",
            "postal_code": "834065810",
            "telephone_number": "208-523-3141",
            "fax_number": "208-525-2661"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1340 S. AMMON ROAD",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "83406",
            "telephone_number": "208-523-3141",
            "fax_number": "208-525-2661"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR MARK D DENNEY OD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-15",
        "last_updated": "2018-06-21",
        "status": "A",
        "authorized_official_last_name": "DENNEY",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "OPTOMETRIST",
        "authorized_official_telephone_number": "208-523-3141",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "ID",
            "license": "ODP1012",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "000010026621",
            "state": "ID"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "805561900",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "V3918",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COLE",
            "identifier": "167539",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Paige Nicole Douty
• Tyler Calvin Downey, PHARMD
• Kirsten Blue Doxey, BS
• Ashley L Doyle
• Dpmcallnrid LLC
• Dr. Facer Psychiatry PLLC
• Dr. James D. Tanner, D.C., P.a.
• James Garl Drake, D.M.D.
• Trevor Lee Drake, CRNA, MHS
• Dreamworks Anesthesia PC

• Optometrist in Idaho Falls, ID
• Providers in Idaho Falls, ID by specialty
• Optometrist in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 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.