Individual provider Active NPI

David Marshall Jr., OD, PHD

  • Optometrist
  • Mentor, OH
National Provider Identifier
1912376377
Registry record updated Apr 21, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
3874 Issued in OH
Practice address
7640 Mentor Ave
Mentor, OH 44060-5420
Phone
(440) 942-3937
NPI assigned
Sep 16, 2015
Last updated
Apr 21, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 21, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 3874 OH Primary

Addresses

Primary practice location

7640 Mentor Ave
Mentor, OH 44060-5420

Mailing address

7640 Mentor Ave
Mentor, OH 44060-5420
Phone (440) 942-3937

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
3874OHMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Dr Sayed Hasan OD Optometrist Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1442361600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1461196800000",
    "number": "1912376377",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7640 MENTOR AVE",
            "city": "MENTOR",
            "state": "OH",
            "postal_code": "440605420",
            "telephone_number": "440-942-3937"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7640 MENTOR AVE",
            "city": "MENTOR",
            "state": "OH",
            "postal_code": "440605420",
            "telephone_number": "440-942-3937"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARSHALL",
        "first_name": "DAVID",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "OD, PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-09-16",
        "last_updated": "2016-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OH",
            "license": "3874",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mentor, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2016; 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.