Organization Active NPI

McCormick Vision PC

  • Optometrist
  • Austin, TX
National Provider Identifier
1285187377
Registry record updated Aug 26, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
MCCORMICK VISION PC
Practice address
12701 Research Blvd
Ste 101
Austin, TX 78759-4386
Phone
(512) 258-2020
Fax
(512) 258-7835
NPI assigned
Jul 26, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 26, 2016

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

Authorized official

Name
Laurie A Long
Title
Insurance Billing Specialist
Phone
(512) 258-9233

Specialties & licenses 1

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

Addresses

Primary practice location

12701 Research Blvd
Ste 101
Austin, TX 78759-4386

Mailing address

12701 Research Blvd
Ste 101
Austin, TX 78759-4386
Phone (512) 258-2020

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20161117000011 TX Part B Supplier - Clinic/Group Practice 5193004083 Receives reassigned benefits from 6 practitioners
Practice locations: Austin, TX

National Provider Directory

National Provider Directory

Locations

12701 Research Blvd
Ste 101
Austin, TX 78759
Phone (512) 258-2020

11044 Research Blvd
Ste C100
Austin, TX 78759
Phone (512) 258-2020

12701 Research Blvd
Austin, TX 78759

Practitioners & affiliated clinicians

Practitioners 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1469491200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1472169600000",
    "number": "1285187377",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12701 RESEARCH BLVD",
            "address_2": "STE 101",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787594386",
            "telephone_number": "512-258-2020",
            "fax_number": "512-258-7835"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12701 RESEARCH BLVD",
            "address_2": "STE 101",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787594386",
            "telephone_number": "512-258-2020",
            "fax_number": "512-258-7835"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MCCORMICK VISION PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-07-26",
        "last_updated": "2016-08-26",
        "status": "A",
        "authorized_official_last_name": "LONG",
        "authorized_official_first_name": "LAURIE",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "INSURANCE BILLING SPECIALIST",
        "authorized_official_telephone_number": "512-258-9233"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Austin, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2016; 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.