NPIMap

Organization Active NPI

Rayner Optical, LLC

  • Durable Medical Equipment & Medical Supplies
  • Oxford, MS
National Provider Identifier
1306957709
Registry record updated Feb 11, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
License
0898070001 Issued in MS
Legal business name
RAYNER OPTICAL, LLC
Practice address
1308 Belk Blvd
Oxford, MS 38655-5302
Phone
(662) 234-0173
NPI assigned
Aug 31, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 11, 2008

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

Authorized official

Name
Thomas M Tann III, MDNPI 1083654578
Title
Owner
Phone
(662) 234-6551

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X 0898070001 MS Primary

Addresses

Primary practice location

1308 Belk Blvd
Oxford, MS 38655-5302

Mailing address

1308 Belk Blvd
Oxford, MS 38655-5302

Other identifiers 2

IdentifierTypeStateIssuer
425720541BOtherMSBLUE CROSS BLUE SHIELD
00880056MedicaidMS

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100930020023 MS DME Supplier - Optician 5991908840 Practice locations: Oxford, MS

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 19

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 19

NPI Registry JSON

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1202688000000",
    "number": "1306957709",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1308 BELK BLVD",
            "city": "OXFORD",
            "state": "MS",
            "postal_code": "386555302"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1308 BELK BLVD",
            "city": "OXFORD",
            "state": "MS",
            "postal_code": "386555302",
            "telephone_number": "662-234-0173"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RAYNER OPTICAL, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-31",
        "last_updated": "2008-02-11",
        "status": "A",
        "authorized_official_last_name": "TANN",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "662-234-6551",
        "authorized_official_name_suffix": "III",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "MS",
            "license": "0898070001",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "425720541B",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00880056",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oxford, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2008; 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.