Individual provider Active NPI

Mark George McEathron, O.D.

  • Optometrist
  • Bellingham, WA
National Provider Identifier
1972595551
Registry record updated Jan 15, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1381 Issued in WA
Practice address
411 E Magnolia St
Bellingham, WA 98225-4510
Phone
(360) 647-2020
Fax
(360) 752-1771
NPI assigned
Aug 18, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 15, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 1381 WA Primary

Addresses

Primary practice location

411 E Magnolia St
Bellingham, WA 98225-4510

Mailing address

411 E Magnolia St
Bellingham, WA 98225-4510
Phone (360) 647-2020

Other identifiers 1

IdentifierTypeStateIssuer
2027548MedicaidWA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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

Enrollment IDStateProvider typePAC IDDetails
I20101130000559 WA Practitioner - Optometry 3779615570 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1381WAMDClinical Neuropsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Binyon Vision Bellingham PLLC Optometrist CurrentSince Sep 1, 2021 Accepting new patients

Locations

411 E Magnolia St
Bellingham, WA 98225
Phone (360) 647-2020

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1124323200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1200355200000",
    "number": "1972595551",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "411 E MAGNOLIA ST",
            "city": "BELLINGHAM",
            "state": "WA",
            "postal_code": "982254510",
            "telephone_number": "360-647-2020",
            "fax_number": "360-752-1771"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "411 E MAGNOLIA ST",
            "city": "BELLINGHAM",
            "state": "WA",
            "postal_code": "982254510",
            "telephone_number": "360-647-2020",
            "fax_number": "360-752-1771"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCEATHRON",
        "first_name": "MARK",
        "middle_name": "GEORGE",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-18",
        "last_updated": "2008-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WA",
            "license": "1381",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2027548",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bellingham, WA

Sources for this page

Verify at the official NPI Registry.