Organization Active NPI

Eye Center of New Albany

  • Optometrist
  • New Albany, MS
National Provider Identifier
1336895507
Registry record updated Jul 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
EYE CENTER OF NEW ALBANY
Practice address
402 Doctors Dr
New Albany, MS 38652-3109
Phone
(662) 539-7771
Fax
(662) 539-7256
NPI assigned
Feb 26, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 14, 2023

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

Authorized official

Name
Dr. Michael Ware, ODNPI 1508980178
Title
Managing Member
Phone
(662) 539-7771

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
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X Primary

Addresses

Primary practice location

402 Doctors Dr
New Albany, MS 38652-3109

Mailing address

402 Doctors Dr
New Albany, MS 38652-3109

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220422001913 MS Part B Supplier - Clinic/Group Practice 5294122180 Receives reassigned benefits from 2 practitioners
Practice locations: New Albany, MS

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1645833600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1689292800000",
    "number": "1336895507",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "402 DOCTORS DR",
            "city": "NEW ALBANY",
            "state": "MS",
            "postal_code": "386523109"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "402 DOCTORS DR",
            "city": "NEW ALBANY",
            "state": "MS",
            "postal_code": "386523109",
            "telephone_number": "662-539-7771",
            "fax_number": "662-539-7256"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EYE CENTER OF NEW ALBANY",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-02-26",
        "last_updated": "2023-07-14",
        "certification_date": "2023-07-14",
        "status": "A",
        "authorized_official_last_name": "WARE",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "662-539-7771",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Albany, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2023; 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.