Active NPI
Mark Allen Weeks, O.D.
- Optometrist
- Wichita, KS
National Provider Identifier
1902931454
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 1115-3
- Practice address
- 9415 E Harry St
Suite 304
Wichita, KS 67207-5089 - Phone
- (316) 686-8209
- Fax
- (316) 686-2192
- NPI assigned
- Feb 23, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 1115-3 | KS | Primary |
Addresses
Primary practice location
9415 E Harry St
Suite 304
Wichita, KS 67207-5089
Mailing address
9415 E Harry St
Suite 304
Wichita, KS 67207-5089
Phone (316) 686-8209
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in KS
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20050330001130 | KS | Practitioner - Optometry | 8426004615 | Practice locations: Wichita, KS |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1115-3 | KS | MD | Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1172188800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1333324800000",
"number": "1902931454",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9415 E HARRY ST",
"address_2": "SUITE 304",
"city": "WICHITA",
"state": "KS",
"postal_code": "672075089",
"telephone_number": "316-686-8209",
"fax_number": "316-686-2192"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9415 E HARRY ST",
"address_2": "SUITE 304",
"city": "WICHITA",
"state": "KS",
"postal_code": "672075089",
"telephone_number": "316-686-8209",
"fax_number": "316-686-2192"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WEEKS",
"first_name": "MARK",
"middle_name": "ALLEN",
"name_prefix": "Dr.",
"credential": "O.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-02-23",
"last_updated": "2012-04-02",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "KS",
"license": "1115-3",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Wichita, KS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.