Michael Robert Merrell, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

D321 Issued in ID

Practice address

1183 Summers Dr
Rexburg, ID 83440-5224

Phone

(208) 356-9097

NPI assigned

Aug 14, 2006

Last updated

Jan 10, 2024By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Merrell Eyecare Center Inc

  • Optometrist
  • Rexburg, ID
  • NPI 1245537885
  NPD (past)

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

{
    "created_epoch": "1155513600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704844800000",
    "number": "1972516607",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1183 SUMMERS DR",
            "city": "REXBURG",
            "state": "ID",
            "postal_code": "834405224",
            "telephone_number": "208-356-9097",
            "fax_number": "208-359-2021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1183 SUMMERS DR",
            "city": "REXBURG",
            "state": "ID",
            "postal_code": "834405224",
            "telephone_number": "208-356-9097"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MERRELL",
        "first_name": "MICHAEL",
        "middle_name": "ROBERT",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-14",
        "last_updated": "2024-01-10",
        "certification_date": "2023-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "ID",
            "license": "D3211",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "ID",
            "license": "D321",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000980900",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Stephen Paul Mellor, D.C.
• Rex Allen Meredith, PA-C
• Robert E. Meredith, DO
• Merrell Eyecare Center Inc
• Marshall H Merrell, O.D.
• Dillon Rhet Merrill, MOTRL
• Mitch Clay Merrill, O.D.
• Nicole Meyer
• MHD Therapies, PLLC (Rehab Specialists of Idaho)
• Allen Terry Miller, PHARMD

• Dentist in Rexburg, ID
• Providers in Rexburg, ID by specialty
• Dentist in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2024; 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.