NPIMap

Organization Active NPI

Myeyedr Optometry of Alabama, LLC

  • Optometrist
  • Cullman, AL
National Provider Identifier
1104488055
Registry record updated May 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
MYEYEDR OPTOMETRY OF ALABAMA, LLC
Practice address
601B Graham St SW
Cullman, AL 35055-5298
Phone
(256) 734-8514
Fax
(256) 734-8392
NPI assigned
Jul 1, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 23, 2022

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

Authorized official

Name
Sue Downes
Title
Secretary
Phone
(703) 847-8899

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X Primary

Addresses

Primary practice location

601B Graham St SW
Cullman, AL 35055-5298

Mailing address

8614 Westwood Center Dr FL 9
Vienna, VA 22182-2442
Phone (703) 847-8899

Other names 1

  • MyEyeDr. Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20180118002553 AL Part B Supplier - Clinic/Group Practice 0840559878 Receives reassigned benefits from 73 practitioners
24 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Hoover, AL; Tuscaloosa, AL; Trussville, AL; Pelham, AL; Mountain BRK, AL; Madison, AL; Irondale, AL; Huntsville, AL…
O20230306000314 AL DME Supplier - Physician - Optometrist 0840559878 Practice locations: Cullman, AL

Other NPIs with the same Medicare PAC ID 3

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 24

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 24

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Myeyedr Optometry of Alabama LLC601B Graham St SW, Cullman, AL 35055-5298(256) 734-8514 Prosthetic Lenses: Conventional Eyeglasses|Prosthetic Lenses: Conventional Contact Lenses Accepts assignmentParticipating since Nov 17, 2017

National Provider Directory

National Provider Directory
Tax ID family
Myeyedr17 organizations share this tax ID, including this one

Other organizations with this tax ID 16

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

View all 16

Locations

5510 Highway 280
Ste 213
Birmingham, AL 35242
Phone (205) 824-7184

445 Providence Main St NW
Ste 102
Huntsville, AL 35806
Phone (256) 722-5425

24810 US Highway 31
Ste 520
Jemison, AL 35085
Phone (205) 319-0680

3143 Pelham Pkwy
Ste 200
Pelham, AL 35124
Phone (205) 358-0227

Practitioners & affiliated clinicians

Practitioners 73

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

View all 73

NPI Registry JSON

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

{
    "created_epoch": "1561939200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1653264000000",
    "number": "1104488055",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8614 WESTWOOD CENTER DR FL 9",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221822442",
            "telephone_number": "703-847-8899",
            "fax_number": "571-223-6780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601B GRAHAM ST SW",
            "city": "CULLMAN",
            "state": "AL",
            "postal_code": "350555298",
            "telephone_number": "256-734-8514",
            "fax_number": "256-734-8392"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MYEYEDR OPTOMETRY OF ALABAMA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-07-01",
        "last_updated": "2022-05-23",
        "certification_date": "2022-05-23",
        "status": "A",
        "authorized_official_last_name": "DOWNES",
        "authorized_official_first_name": "SUE",
        "authorized_official_title_or_position": "SECRETARY",
        "authorized_official_telephone_number": "703-847-8899"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MyEyeDr.",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "MyEyeDr.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Cullman, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.