Mitchellville Eye Associates

Primary specialty

OptometristTaxonomy code 152W00000X

Legal business name

MITCHELLVILLE EYE ASSOCIATES

Practice address

10476 Campus Way S
Largo, MD 20774-1304

Phone

(301) 336-4040

Fax

(301) 350-6690

NPI assigned

Oct 23, 2006

Organization subpart

No

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

Authorized official

Name

Miss Fred Smith

Title

Owner

Phone

(301) 336-4040

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1161561600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1295818268",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10476 CAMPUS WAY S",
            "city": "LARGO",
            "state": "MD",
            "postal_code": "207741304",
            "telephone_number": "301-336-4040",
            "fax_number": "301-350-6690"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10476 CAMPUS WAY S",
            "city": "LARGO",
            "state": "MD",
            "postal_code": "207741304",
            "telephone_number": "301-336-4040",
            "fax_number": "301-350-6690"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MITCHELLVILLE EYE ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-23",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "FRED",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "301-336-4040",
        "authorized_official_name_prefix": "Miss"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Optometrist in Largo, MD
• Providers in Largo, MD by specialty
• Optometrist in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.