Active NPI
Mark George McEathron, O.D.
- Optometrist
- Bellingham, WA
National Provider Identifier
1972595551
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 1381
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2027548 | Medicaid | WA |
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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1381 | WA | MD | Clinical Neuropsychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Binyon Vision Bellingham PLLC | Optometrist | Current | 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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2008; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.