Moore Vision Center, PLLC

Primary specialty

OptometristTaxonomy code 152W00000X

License

1064-OD Issued in WV

Legal business name

MOORE VISION CENTER, PLLC

Practice address

467 Main St
Suite 401
Madison, WV 25130-2200

Phone

(304) 654-4803

NPI assigned

Feb 17, 2010

Organization subpart

No

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

Authorized official

Name

Dr. Marty Braxton Moore, O.D.NPI 1326279217

Title

Optometrist

Phone

(304) 654-4803

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WV

Enrollment records 1

Tax ID family

Moore Vision Center PLLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Moore Vision Center, PLLC

  • Eyewear Supplier
  • Madison, WV
  • NPI 1639573264
  NPD tax ID

Locations

Practitioners 1

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

• Marty Braxton Moore, O.D.

  • Optometrist
  • South Charleston, WV
  • NPI 1326279217
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1266364800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1266364800000",
    "number": "1043532153",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "467 MAIN ST",
            "address_2": "SUITE 401",
            "city": "MADISON",
            "state": "WV",
            "postal_code": "251302200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "467 MAIN ST",
            "address_2": "SUITE 401",
            "city": "MADISON",
            "state": "WV",
            "postal_code": "251302200",
            "telephone_number": "304-654-4803"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOORE VISION CENTER, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-02-17",
        "last_updated": "2010-02-17",
        "status": "A",
        "authorized_official_last_name": "MOORE",
        "authorized_official_first_name": "MARTY",
        "authorized_official_middle_name": "BRAXTON",
        "authorized_official_title_or_position": "OPTOMETRIST",
        "authorized_official_telephone_number": "304-654-4803",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "WV",
            "license": "1064-OD",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Goldie Lee Miller
• Mishalla Miller
• Scotty Miller I
• Shawn Miller
• Janet Marie Mitchell
• Moore Vision Center, PLLC
• Stephanie Faye Moore
• Lillian Grace Moreland
• Lillian Morgan
• Jennifer Morris

• Optometrist in Madison, WV
• Providers in Madison, WV by specialty
• Optometrist in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.