Active NPI
Mobile Optical Inc
- Optician
- Bowie, MD
National Provider Identifier
1104351881
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optician
- 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
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Optician | 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3387101 | Medicaid | MD |
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Optometrist
- Hackensack, NJ
- NPI 1003129495
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.