NPIMap

Organization Active NPI

Mountaineer Optical Inc

  • Eyewear Supplier
  • Elkins, WV
National Provider Identifier
1326109331
Registry record updated Oct 5, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Eyewear SupplierTaxonomy code 332H00000X
Legal business name
MOUNTAINEER OPTICAL INC
Practice address
116 3Rd St
Elkins, WV 26241
Phone
(304) 636-7046
Fax
(304) 636-7046
NPI assigned
Dec 13, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 5, 2010

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

Authorized official

Name
Mrs. Penny J Doyle
Title
Vice President
Phone
(304) 636-7046

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Eyewear Supplier 332H00000X Primary

Addresses

Primary practice location

116 3Rd St
Elkins, WV 26241

Mailing address

116 3Rd St
Elkins, WV 26241
Phone (304) 636-7046

Other identifiers 1

IdentifierTypeStateIssuer
0151814000MedicaidWV

National Provider Directory

National Provider Directory

Locations

116 3rd St
Elkins, WV 26241
Phone (304) 636-7046

NPI Registry JSON

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

{
    "created_epoch": "1165968000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1286236800000",
    "number": "1326109331",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "116 3RD ST",
            "city": "ELKINS",
            "state": "WV",
            "postal_code": "26241",
            "telephone_number": "304-636-7046",
            "fax_number": "304-636-7046"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "116 3RD ST",
            "city": "ELKINS",
            "state": "WV",
            "postal_code": "26241",
            "telephone_number": "304-636-7046",
            "fax_number": "304-636-7046"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOUNTAINEER OPTICAL INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-13",
        "last_updated": "2010-10-05",
        "status": "A",
        "authorized_official_last_name": "DOYLE",
        "authorized_official_first_name": "PENNY",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "304-636-7046",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0151814000",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Elkins, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2010; 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.