Active NPI
Dr Mark C Hurst Optometrist LTD
- Eyewear Supplier
- Mount Vernon, IL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Eyewear Supplier
- Legal business name
- DR MARK C HURST OPTOMETRIST LTD
- Practice address
- 4 Westwood Dr
Mount Vernon, IL 62864-2212 - Phone
- (618) 242-7810
- NPI assigned
- Mar 10, 2008
- Last updated
- Jul 21, 2022
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Mark Claude Hurst, O.D.
- Title
- President
- Phone
- (618) 242-7810
Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Eyewear Supplier | 332H00000X | NU | Primary |
Addresses
Primary practice location
4 Westwood Dr
Mount Vernon, IL 62864-2212
Mailing address
4 Westwood Dr
Mount Vernon, IL 62864-2212
Phone (618) 242-7810
Other practice location 1
208 E 3rd St
Centralia, IL 62801-3902
Phone (618) 532-2537
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20100930080681 | IL | DME Supplier - Physician - Optometrist | 9133272958 | Practice locations: Mount Vernon, IL |
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
Medicare medical equipment & supply locations
| Supplier | Supplies | Medicare assignment |
|---|---|---|
| Dr Mark C Hurst Optometrist LTD | Prosthetic Lenses: Conventional Eyeglasses|Prosthetic Lenses: Conventional Contact Lenses|Prosthetic Lenses: Prosthetics Cataract Lenses | Accepts assignment |
National Provider Directory
National Provider DirectoryLocations
308 E Broadway
Centralia, IL 62801
Phone (618) 532-2537
Practitioners & affiliated clinicians
Practitioners 1
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.
-
- Optometrist
- Mount Vernon, IL
- NPI 1912979311
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1205107200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1658361600000",
"number": "1851561575",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4 WESTWOOD DR",
"city": "MOUNT VERNON",
"state": "IL",
"postal_code": "628642212",
"telephone_number": "618-242-7810"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4 WESTWOOD DR",
"city": "MOUNT VERNON",
"state": "IL",
"postal_code": "628642212",
"telephone_number": "618-242-7810"
}
],
"practiceLocations": [
{
"address_1": "208 E 3rd St",
"address_purpose": "LOCATION",
"city": "Centralia",
"state": "IL",
"postal_code": "628013902",
"country_code": "US",
"telephone_number": "618-532-2537",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"organization_name": "DR MARK C HURST OPTOMETRIST LTD",
"organizational_subpart": "NO",
"enumeration_date": "2008-03-10",
"last_updated": "2022-07-21",
"status": "A",
"authorized_official_last_name": "HURST",
"authorized_official_first_name": "MARK",
"authorized_official_middle_name": "CLAUDE",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "618-242-7810",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "O.D."
},
"taxonomies": [
{
"code": "332H00000X",
"taxonomy_group": "",
"desc": "Eyewear Supplier",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Mount Vernon, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.