Organization Active NPI

Dr Mark C Hurst Optometrist LTD

  • Eyewear Supplier
  • Mount Vernon, IL
National Provider Identifier
1851561575
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Eyewear SupplierTaxonomy code 332H00000X
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, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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.NPI 1912979311
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)CodeLicenseStatePrimary
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 IDStateProvider typePAC IDDetails
O20100930080681 IL DME Supplier - Physician - Optometrist 9133272958 Practice locations: Mount Vernon, IL

Laboratory certificates & supplier records

Derived by NPIMap

These 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

SupplierSuppliesMedicare assignment
Dr Mark C Hurst Optometrist LTD4 Westwood Dr, Mount Vernon, IL 62864-2212(618) 242-7810 Prosthetic Lenses: Conventional Eyeglasses|Prosthetic Lenses: Conventional Contact Lenses|Prosthetic Lenses: Prosthetics Cataract Lenses Accepts assignmentParticipating since Jan 1, 1992

National Provider Directory

National Provider Directory

Locations

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.

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.

Verify at the official NPI Registry.