Individual provider Active NPI

Carmen Bailey Mackey, O.D.

  • Optometrist
  • Center, TX
National Provider Identifier
1144474404
Registry record updated Jan 7, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
7261TG Issued in TX
Practice address
702 Louisiana St
Center, TX 75935-3672
Phone
(936) 598-8501
Fax
(936) 598-2311
NPI assigned
Nov 12, 2008
Last updated
Jan 7, 2010By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 7, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 7261TG TX Primary

Addresses

Primary practice location

702 Louisiana St
Center, TX 75935-3672

Mailing address

PO Box 1838
Center, TX 75935-1838
Phone (936) 598-8501

Other identifiers 1

IdentifierTypeStateIssuer
7261TGOtherTXOPTOMETRY LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100121000210 TX Practitioner - Optometry 4183766645 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University of Houston - College of Optometry, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ihlo Enterprises, PLLCGroup PAC ID 4385170877, 2 clinicians

Practice addresses (Care Compare)

702 Louisiana St
Center, TX 75935-3672
Phone (936) 598-8501

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery33

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
7261TGTXMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
David Dixon Golden, OD, PA Optometrist CurrentSince Jan 1, 2010 Accepting new patients
Pineywoods Eye Associates P a Optometrist CurrentSince Dec 14, 2009 Accepting new patients
Pineywoods Eye Associates P a Optometrist CurrentSince Dec 14, 2009 Accepting new patients
Ihlo Enterprises, PLLC Optometrist CurrentSince Oct 10, 2024 Accepting new patients

Locations

702 Louisiana St
Center, TX 75935
Phone (409) 598-8501

4729 NE Stallings Dr
Nacogdoches, TX 75965
Phone (936) 564-2634

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1226448000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1262822400000",
    "number": "1144474404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1838",
            "city": "CENTER",
            "state": "TX",
            "postal_code": "759351838",
            "telephone_number": "936-598-8501",
            "fax_number": "936-598-2311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "702 LOUISIANA ST",
            "city": "CENTER",
            "state": "TX",
            "postal_code": "759353672",
            "telephone_number": "936-598-8501",
            "fax_number": "936-598-2311"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACKEY",
        "first_name": "CARMEN",
        "middle_name": "BAILEY",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-11-12",
        "last_updated": "2010-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "7261TG",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OPTOMETRY LICENSE",
            "identifier": "7261TG",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Center, TX

Sources for this page

Verify at the official NPI Registry.