Organization Active NPI

Mobile Optical Inc

  • Optician
  • Bowie, MD
National Provider Identifier
1104351881
Registry record updated May 1, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
OpticianTaxonomy code 156FX1800X
Legal business name
MOBILE OPTICAL INC
Practice address
12407 Sussex LN
Bowie, MD 20715-3148
Phone
(443) 926-4435
NPI assigned
May 1, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 1, 2017

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

Authorized official

Name
Donna Feger
Title
Owner
Phone
(443) 926-4435

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OpticianGroup: 193400000X SINGLE SPECIALTY GROUP 156FX1800X Primary

Addresses

Primary practice location

12407 Sussex LN
Bowie, MD 20715-3148

Mailing address

477 86TH Ave
St Pete Beach, FL 33706-1532
Phone (443) 926-4435

Other identifiers 1

IdentifierTypeStateIssuer
3387101MedicaidMD

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1493596800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1493596800000",
    "number": "1104351881",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "477 86TH AVE",
            "city": "ST PETE BEACH",
            "state": "FL",
            "postal_code": "337061532",
            "telephone_number": "443-926-4435"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12407 SUSSEX LN",
            "city": "BOWIE",
            "state": "MD",
            "postal_code": "207153148",
            "telephone_number": "443-926-4435"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOBILE OPTICAL INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-05-01",
        "last_updated": "2017-05-01",
        "status": "A",
        "authorized_official_last_name": "FEGER",
        "authorized_official_first_name": "DONNA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "443-926-4435"
    },
    "taxonomies": [
        {
            "code": "156FX1800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Technician/Technologist, Optician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3387101",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bowie, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2017; 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.