Individual provider Active NPI

Mark Allen Weeks, O.D.

  • Optometrist
  • Wichita, KS
National Provider Identifier
1902931454
Registry record updated Apr 2, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1115-3 Issued in KS
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

Updated by the provider on Apr 2, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050330001130 KS Practitioner - Optometry 8426004615 Practice locations: Wichita, KS

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1115-3KSMDOptometrist

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

Verify at the official NPI Registry.