Mar-Tan Family Vision Center

Primary specialty

OpticianTaxonomy code 156FX1800X

License

KY325 Issued in KY

Legal business name

MAR-TAN FAMILY VISION CENTER

Practice address

205 Geri LN
Richmond, KY 40475-2359

Phone

(859) 623-4267

Fax

(859) 623-4249

NPI assigned

Aug 9, 2005

Organization subpart

No

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

Authorized official

Name

Mr. Jimmie T Phelps

Title

Owner / Optician

Phone

(859) 623-4267

Specialties & licenses 1

Addresses

Other identifiers 9

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Thea T. Shearer, O.D.

  • Optometrist
  • Richmond, KY
  • NPI 1073514204
  NPD (past)

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

{
    "created_epoch": "1123545600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1261440000000",
    "number": "1033110291",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "205 GERI LN",
            "city": "RICHMOND",
            "state": "KY",
            "postal_code": "404752359",
            "telephone_number": "859-623-4267",
            "fax_number": "859-623-4249"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 GERI LN",
            "city": "RICHMOND",
            "state": "KY",
            "postal_code": "404752359",
            "telephone_number": "859-623-4267",
            "fax_number": "859-623-4249"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAR-TAN FAMILY VISION CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-09",
        "last_updated": "2009-12-22",
        "status": "A",
        "authorized_official_last_name": "PHELPS",
        "authorized_official_first_name": "JIMMIE",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "OWNER / OPTICIAN",
        "authorized_official_telephone_number": "859-623-4267",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "156FX1800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Technician/Technologist, Optician",
            "state": "KY",
            "license": "KY325",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CVC",
            "identifier": "32646",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "52903259",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "260155886",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "52800919",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000195501",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CHA",
            "identifier": "1188575",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "2537729",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EYEMED",
            "identifier": "OP0933",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PVC",
            "identifier": "1141",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Stephanie C Maggard, LPCC
• Grant Maglinger, DMD
• Paula M Maionchi, MD
• Diana Lynn Mansfield, LMT
• Michael Patrick Mansfield, LMT
• Amber Marcum, LCSW
• Jordan Marcum
• Keaira McKenzi-Tiheya Marcum, DR
• Mark O. Cummins, DMD, PLLC
• Robyn Justice Marques, OTR/L

• Optician in Richmond, KY
• Providers in Richmond, KY by specialty
• Optician in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2009; 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.