NPIMap

Organization Active NPI

Moberly Eye Center Inc

  • Optometrist
  • Moberly, MO
National Provider Identifier
1215058243
Registry record updated Jan 23, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
T03120 Issued in MO
Legal business name
MOBERLY EYE CENTER INC
Practice address
1633 S Morley St
Moberly, MO 65270-1938
Phone
(660) 263-4261
Fax
(660) 263-0958
NPI assigned
Apr 3, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2009

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

Authorized official

Name
Dr. David Whitson, OD
Title
President
Phone
(660) 263-4261

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X T03120 MO Primary

Addresses

Primary practice location

1633 S Morley St
Moberly, MO 65270-1938

Mailing address

PO Box 696
Moberly, MO 65270-0696
Phone (660) 263-4261

Other identifiers 1

IdentifierTypeStateIssuer
318272812MedicaidMO

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1175558400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1232668800000",
    "number": "1215058243",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 696",
            "city": "MOBERLY",
            "state": "MO",
            "postal_code": "652700696",
            "telephone_number": "660-263-4261",
            "fax_number": "660-263-0958"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1633 S MORLEY ST",
            "city": "MOBERLY",
            "state": "MO",
            "postal_code": "652701938",
            "telephone_number": "660-263-4261",
            "fax_number": "660-263-0958"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOBERLY EYE CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-03",
        "last_updated": "2009-01-23",
        "status": "A",
        "authorized_official_last_name": "WHITSON",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "660-263-4261",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "MO",
            "license": "T03120",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "318272812",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Moberly, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2009; 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.