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Deactivated NPI 1578692968 Deactivated / Inactive NPI Male Practitioner

Dr. Mark Desmon Roudebush , OD

Optometrist • Dayton, OH

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Dr. Mark Roudebush has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date March 03, 2007
NPI Deactivation Date March 23, 2017
Total Practice Duration ~10 Years of Practice (2007 – 2017)

Professional Overview & Biography Verified Profile Summary

Dr. Mark Roudebush, OD was a registered Optometrist practicing in Dayton, OH. Throughout an active medical career spanning 10 years, Dr. Roudebush provided care at the practice location at 5419 N MAIN ST until profile deactivation on 2017-03-23.

Practice Location & Contact Primary Location

Practice Address

5419 N Main St

Dayton, OH 454153454

Telephone 9372780675
Associated Practice Facility / Clinic
🏢 Shiloh Optometric Center Inc Facility NPI 1104993229

Specialty Benchmarks & Practice Insights

Comparative analytics for Optometrist in Dayton, OH

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 23.3 Yrs
State Avg: 23.4 Yrs
Regional Practice Density
61 Specialists

Practicing in Dayton, OH (2535 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Optometrist Primary Specialty

NUCC Taxonomy Code: 152W00000X

State License OH 5771

Doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

2 Associated Practitioners
NPI 1659378339

Doctor of Optometry

NPI 1942207717

Doctor of Optometry

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events
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NPI Profile Deactivated March 23, 2017

Record deactivated on March 23, 2017

NPI Profile Active August 31, 2015

NPI status registered as active in NPPES database

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Updated Practice Location August 31, 2015

Registered at 5419 N MAIN ST, DAYTON, OH 454153454 (Tel: 9372780675)

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Updated Business Mailing Address August 31, 2015

Registered at 191 W OLENTANGY ST, UNIT F, POWELL, OH 430658680 (Tel: 6146197973)

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Provider Name / Credentials Updated August 31, 2015

Recorded as MARK ROUDEBUSH, O. D.

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Medical Taxonomy / Specialty Registered (Primary Specialty) August 31, 2015

Optometrist (License #5771 in OH)

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Initial NPI Registration & Enumeration March 03, 2007

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1578692968
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: March 03, 2007
Last Update: August 31, 2015
Deactivation Date: March 23, 2017

Mailing Address

191 W Olentangy St, Unit F

Powell, OH 430658680

Phone: 6146197973

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

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