Mixan Eyecare, Inc.

Primary specialty

OptometristTaxonomy code 152W00000X

License

1455 Issued in NE

Legal business name

MIXAN EYECARE, INC.

Practice address

12424 W Dodge Rd Ste 104
Omaha, NE 68154-2322

Phone

(531) 233-5680

Fax

(531) 215-0937

NPI assigned

Mar 30, 2017

Last updated

Dec 21, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mark Mixan, ODNPI 1093197204

Title

President

Phone

(641) 373-1951

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NE

Enrollment records 1

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Mark Mixan, O.D.

  • Optometrist
  • Omaha, NE
  • NPI 1093197204
  Medicare reassignment NPD Authorized official
• Janna L Mixan, O.D.

  • Optometrist
  • Omaha, NE
  • NPI 1770965659
  Medicare reassignment NPD

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

{
    "created_epoch": "1490832000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1671580800000",
    "number": "1184156069",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "805 W CENTENNIAL RD",
            "city": "PAPILLION",
            "state": "NE",
            "postal_code": "680467017",
            "telephone_number": "531-233-5680",
            "fax_number": "531-215-0937"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12424 W DODGE RD STE 104",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681542322",
            "telephone_number": "531-233-5680",
            "fax_number": "531-215-0937"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIXAN EYECARE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-03-30",
        "last_updated": "2022-12-21",
        "certification_date": "2022-12-21",
        "status": "A",
        "authorized_official_last_name": "MIXAN",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "641-373-1951",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NE",
            "license": "1455",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nickiya Mitchelle
• James Mitchelson, M.D.
• Angelyna Mitchem
• Egnonche Mitchozounnou
• Holly Mitzel, MD
• Gabriella Mixan
• Janna L Mixan, O.D.
• Kristy Lynn Mixan
• Mark Mixan, O.D.
• Nicole Marie Mixan, APRN

• Optometrist in Omaha, NE
• Providers in Omaha, NE by specialty
• Optometrist in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2022; 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.