Active NPI
Marcus Lavelle Meadows, O.D.
- Optometrist
- Glen Burnie, MD
National Provider Identifier
1306924386
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- TA1730
- Practice address
- 6721 Chesapeake Center Drive
Glen Burnie, MD 21060 - Phone
- (410) 863-1290
- Fax
- (410) 863-1292
- NPI assigned
- Nov 1, 2006
- Last updated
- Aug 11, 2016
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | TA1730 | MD | Primary |
Addresses
Primary practice location
6721 Chesapeake Center Drive
Glen Burnie, MD 21060
Mailing address
3203 Abacus CT
Bowie, MD 20716-3883
Phone (301) 464-0178
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 020581860 | Medicaid | MD |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| TA1730 | MD | MD | Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1162339200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1470873600000",
"number": "1306924386",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3203 ABACUS CT",
"city": "BOWIE",
"state": "MD",
"postal_code": "207163883",
"telephone_number": "301-464-0178",
"fax_number": "410-863-1292"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6721 CHESAPEAKE CENTER DRIVE",
"city": "GLEN BURNIE",
"state": "MD",
"postal_code": "21060",
"telephone_number": "410-863-1290",
"fax_number": "410-863-1292"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MEADOWS",
"first_name": "MARCUS",
"middle_name": "LAVELLE",
"name_prefix": "Dr.",
"credential": "O.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-11-01",
"last_updated": "2016-08-11",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "MD",
"license": "TA1730",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "020581860",
"state": "MD"
}
],
"endpoints": [],
"other_names": []
}Other providers in Glen Burnie, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.