Individual provider Active NPI

Harold Lee Poynter III, O. D.

  • Optometrist
  • Maryville, MO
National Provider Identifier
1205961539
Registry record updated Sep 12, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
T02150 Issued in MO
Practice address
503 S Main St
Maryville, MO 64468-2444
Phone
(660) 582-5222
Fax
(660) 582-6558
NPI assigned
Feb 23, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X T02150 MO Primary

Addresses

Primary practice location

503 S Main St
Maryville, MO 64468-2444

Mailing address

503 S Main St
Maryville, MO 64468-2444
Phone (660) 582-5222

Other identifiers 1

IdentifierTypeStateIssuer
17316019OtherMOBLUE CROSS BLUE SHIELD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1172188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1347408000000",
    "number": "1205961539",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "503 S MAIN ST",
            "city": "MARYVILLE",
            "state": "MO",
            "postal_code": "644682444",
            "telephone_number": "660-582-5222",
            "fax_number": "660-582-6558"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "503 S MAIN ST",
            "city": "MARYVILLE",
            "state": "MO",
            "postal_code": "644682444",
            "telephone_number": "660-582-5222",
            "fax_number": "660-582-6558"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POYNTER",
        "first_name": "HAROLD",
        "middle_name": "LEE",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "O. D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-23",
        "last_updated": "2012-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MO",
            "license": "T02150",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "17316019",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Maryville, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2012; 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.