Organization Active NPI

Reflections Vision Center

  • Optometrist
  • Madison, MS
National Provider Identifier
1144586546
Registry record updated Apr 10, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
788 Issued in MS
Legal business name
REFLECTIONS VISION CENTER
Practice address
101-C Lexington Dr.
Madison, MS 39110
Phone
(601) 255-5052
NPI assigned
Apr 10, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 10, 2012

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

Authorized official

Name
Dr. Marjorie Lenoir, O.D.NPI 1154514578
Title
Optometrist
Phone
(601) 255-5052

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 788 MS Primary

Addresses

Primary practice location

101-C Lexington Dr.
Madison, MS 39110

Mailing address

101-C Lexington Dr.
Madison, MS 39110

Other identifiers 1

IdentifierTypeStateIssuer
04324730MedicaidMS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120720000298 MS Part B Supplier - Clinic/Group Practice 7719143692 Receives reassigned benefits from 1 practitioner
Practice locations: Madison, MS; Gluckstadt, MS

National Provider Directory

National Provider Directory

Locations

101 Lexington Dr
Ste C
Gluckstadt, MS 39110
Phone (601) 255-5052

2129 Grand Ave
Yazoo City, MS 39194
Phone (662) 673-4020

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": "1334016000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1334016000000",
    "number": "1144586546",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101-C LEXINGTON DR.",
            "city": "MADISON",
            "state": "MS",
            "postal_code": "39110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101-C LEXINGTON DR.",
            "city": "MADISON",
            "state": "MS",
            "postal_code": "39110",
            "telephone_number": "601-255-5052"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REFLECTIONS VISION CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-04-10",
        "last_updated": "2012-04-10",
        "status": "A",
        "authorized_official_last_name": "LENOIR",
        "authorized_official_first_name": "MARJORIE",
        "authorized_official_title_or_position": "OPTOMETRIST",
        "authorized_official_telephone_number": "601-255-5052",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "MS",
            "license": "788",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "04324730",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Madison, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.