Active NPI
Douglas Lee Mann Jr., OD
- Optometrist
- Decatur, AL
National Provider Identifier
1346302833
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- S418TA-311
- Practice address
- 1616 Beltline Rd SW
Decatur, AL 35601 - Phone
- (256) 355-9645
- Fax
- (256) 353-7116
- NPI assigned
- Dec 14, 2006
- Sex
- Male
- Sole proprietor
- No
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 | S418TA-311 | AL | Primary |
Addresses
Primary practice location
1616 Beltline Rd SW
Decatur, AL 35601
Mailing address
1616 Beltline Rd SW
Decatur, AL 35601
Phone (256) 355-9645
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 25041 | Other | SPECTERA | |
| A10418 | Other | COLE EYE MED |
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| S418TA-311 | AL | MD | Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1166054400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1346302833",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1616 BELTLINE RD SW",
"city": "DECATUR",
"state": "AL",
"postal_code": "35601",
"telephone_number": "256-355-9645",
"fax_number": "256-353-7116"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1616 BELTLINE RD SW",
"city": "DECATUR",
"state": "AL",
"postal_code": "35601",
"telephone_number": "256-355-9645",
"fax_number": "256-353-7116"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MANN",
"first_name": "DOUGLAS",
"middle_name": "LEE",
"name_prefix": "Dr.",
"name_suffix": "Jr.",
"credential": "OD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-12-14",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "AL",
"license": "S418TA-311",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "SPECTERA",
"identifier": "25041",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "COLE EYE MED",
"identifier": "A10418",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Decatur, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.