NPIMap

Organization Active NPI

Optimart, Inc.

  • Optician
  • Port Richey, FL
National Provider Identifier
1124235049
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
OpticianTaxonomy code 156FX1800X
License
OE391 Issued in FL
Legal business name
OPTIMART, INC.
Practice address
10041A US Highway 19
Port Richey, FL 34668-3742
Phone
(727) 868-0780
Fax
(727) 868-0819
NPI assigned
May 17, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Gregory Louis Mathis
Title
Administrator
Phone
(727) 812-3020

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OpticianGroup: 193400000X SINGLE SPECIALTY GROUP 156FX1800X OE391 FL Primary

Addresses

Primary practice location

10041A US Highway 19
Port Richey, FL 34668-3742

Mailing address

4399 35TH St N
St Petersburg, FL 33714-3717
Phone (727) 812-3020

Other names 1

  • OPTIMART, INC. #08 Doing business as

National Provider Directory

National Provider Directory

Locations

10041 US Highway 19
Ste A
Port Richey, FL 34668
Phone (727) 859-9009

NPI Registry JSON

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

{
    "created_epoch": "1179360000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1124235049",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4399 35TH ST N",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337143717",
            "telephone_number": "727-812-3020",
            "fax_number": "727-525-4835"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10041A US HIGHWAY 19",
            "city": "PORT RICHEY",
            "state": "FL",
            "postal_code": "346683742",
            "telephone_number": "727-868-0780",
            "fax_number": "727-868-0819"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OPTIMART, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-17",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MATHIS",
        "authorized_official_first_name": "GREGORY",
        "authorized_official_middle_name": "LOUIS",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "727-812-3020"
    },
    "taxonomies": [
        {
            "code": "156FX1800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Technician/Technologist, Optician",
            "state": "FL",
            "license": "OE391",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "OPTIMART, INC. #08",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Port Richey, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.