Marshall H Merrell, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

ODP813 Issued in ID

Practice address

46 Professional PLZ
Rexburg, ID 83440-2047

Phone

(208) 359-2020

Fax

(208) 359-2021

NPI assigned

Oct 12, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 5

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

• Madison Co Memorial Hospital

  • Obstetrics & Gynecology Physician
  • Rexburg, ID
  • NPI 1073154266

  Other

  CMS ownership
• Madison Co Memorial Hospital

  • General Acute Care Hospital
  • Rexburg, ID
  • NPI 1992747570

  Other

  CMS ownership

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.

• Eyecare Center Idaho Falls LLC

  • Optometrist
  • Idaho Falls, ID
  • NPI 1568262111

  ID, Optometrist

  Medicare reassignment NPD
• Eyecare Center Rexburg LLC

  • Optometrist
  • Rexburg, ID
  • NPI 1477353902

  ID, Optometrist

  Medicare reassignment NPD

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

{
    "created_epoch": "1160611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1489968000000",
    "number": "1992894232",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "345 N 2ND E",
            "address_2": "STE 1",
            "city": "REXBURG",
            "state": "ID",
            "postal_code": "834401603",
            "telephone_number": "208-359-2020",
            "fax_number": "208-359-2021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "46 PROFESSIONAL PLZ",
            "city": "REXBURG",
            "state": "ID",
            "postal_code": "834402047",
            "telephone_number": "208-359-2020",
            "fax_number": "208-359-2021"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MERRELL",
        "first_name": "MARSHALL",
        "middle_name": "H",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-12",
        "last_updated": "2017-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "ID",
            "license": "ODP813",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE BLUE SHIELD",
            "identifier": "000010015276",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS OF IDAHO",
            "identifier": "V7261",
            "state": "ID"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "002652200",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE BLUE SHIELD",
            "identifier": "000010015275",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS OF IDAHO",
            "identifier": "V3058",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mellor Chiropractic Clinic P.a.
• Stephen Paul Mellor, D.C.
• Rex Allen Meredith, PA-C
• Robert E. Meredith, DO
• Merrell Eyecare Center Inc
• Michael Robert Merrell, DDS
• Dillon Rhet Merrill, MOTRL
• Mitch Clay Merrill, O.D.
• Nicole Meyer
• MHD Therapies, PLLC

• All providers in Rexburg, ID
• Optometrist in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.