Mark D Denney, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

ODP1012 Issued in ID

Practice address

1340 S Ammon Rd
Ammon, ID 83406-5810

Phone

(208) 523-3141

Fax

(208) 525-2661

NPI assigned

Jan 2, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in ID

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Optometry

Education

Southern California College of Optometry, 1999

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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

• Dr Mark D Denney OD PA

  • Optometrist
  • Idaho Falls, ID
  • NPI 1780890541
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1167696000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1275436800000",
    "number": "1962569681",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1340 S AMMON RD",
            "city": "AMMON",
            "state": "ID",
            "postal_code": "834065810",
            "telephone_number": "208-523-3141",
            "fax_number": "208-525-2661"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1340 S AMMON RD",
            "city": "AMMON",
            "state": "ID",
            "postal_code": "834065810",
            "telephone_number": "208-523-3141",
            "fax_number": "208-525-2661"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DENNEY",
        "first_name": "MARK",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-02",
        "last_updated": "2010-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "ID",
            "license": "ODP1012",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "000010026621",
            "state": "ID"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "805561900",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "V3918",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COLE",
            "identifier": "167539",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Joshua G Davis, O.D.
• Pamela Davis, CPSS
• Delayna Day
• Stephen A Denagy, M4915
• Jodi Lynn Dennett
• Lance Denning, PHARMD
• Amy Lynn Diaz, CBRS, CASE MANAGER
• Spencer Louis Dietz, PHARMD, RPH
• Sean Dixon
• Caylie Mae Dole

• Optometrist in Ammon, ID
• Providers in Ammon, ID by specialty
• Optometrist in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2010; 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.
• 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.