Mark D. Livaditis, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

0618000747 Issued in VA

Legal business name

MARK D. LIVADITIS, O.D.

Practice address

5250 G Port Royal Rd
Springfield, VA 22151-2117

Phone

(703) 321-7780

Fax

(703) 321-2205

NPI assigned

Feb 6, 2009

Organization subpart

No

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

Authorized official

Name

Dr. Mark D Livaditis, O.D.

Title

Owner

Phone

(703) 321-7780

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1233878400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1251158400000",
    "number": "1912146499",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5250 G PORT ROYAL RD",
            "city": "SPRINGFIELD",
            "state": "VA",
            "postal_code": "221512117",
            "telephone_number": "703-321-7780",
            "fax_number": "703-321-2205"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5250 G PORT ROYAL RD",
            "city": "SPRINGFIELD",
            "state": "VA",
            "postal_code": "221512117",
            "telephone_number": "703-321-7780",
            "fax_number": "703-321-2205"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARK D. LIVADITIS, O.D.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-02-06",
        "last_updated": "2009-08-25",
        "status": "A",
        "authorized_official_last_name": "LIVADITIS",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "703-321-7780",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": "VA",
            "license": "0618000747",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Optometrist in Springfield, VA
• Providers in Springfield, VA by specialty
• Optometrist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.