NPIMap

Organization Active NPI

Malbar Vision

  • Optometrist
  • Lincoln, NE
National Provider Identifier
1326317082
Registry record updated Dec 23, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
0763 Issued in NE
Legal business name
MALBAR VISION
Practice address
3200 O St Ste a
Lincoln, NE 68510-1510
Phone
(402) 475-9113
Fax
(402) 475-8084
NPI assigned
Dec 23, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 23, 2011

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

Authorized official

Name
Miss Jaimi Lee Rose
Title
Office Manager
Phone
(402) 475-9113

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 0763 NE Primary

Addresses

Primary practice location

3200 O St Ste a
Lincoln, NE 68510-1510

Mailing address

3200 O St Ste a
Lincoln, NE 68510-1510
Phone (402) 475-9113

Other identifiers 1

IdentifierTypeStateIssuer
10026004700MedicaidNE

National Provider Directory

National Provider Directory

Locations

3200 O St
Ste A
Lincoln, NE 68510
Phone (402) 475-9113

NPI Registry JSON

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

{
    "created_epoch": "1324598400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1324598400000",
    "number": "1326317082",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3200 O ST STE A",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685101510",
            "telephone_number": "402-475-9113",
            "fax_number": "402-475-8084"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3200 O ST STE A",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685101510",
            "telephone_number": "402-475-9113",
            "fax_number": "402-475-8084"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MALBAR VISION",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-12-23",
        "last_updated": "2011-12-23",
        "status": "A",
        "authorized_official_last_name": "ROSE",
        "authorized_official_first_name": "JAIMI",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "402-475-9113",
        "authorized_official_name_prefix": "Miss"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "NE",
            "license": "0763",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10026004700",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lincoln, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2011; 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.