Organization Active NPI

Legacy Eye Care

  • Optometrist
  • Huntsville, AL
National Provider Identifier
1356146013
Registry record updated Feb 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
LEGACY EYE CARE
Practice address
6140A University Dr NW
Huntsville, AL 35806-1710
Phone
(256) 837-5642
Fax
(256) 803-2384
NPI assigned
Feb 17, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 17, 2025

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

Authorized official

Name
Dr. Latisha Marbuary, ODNPI 1720391675
Title
Owner
Phone
(205) 370-9430

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

6140A University Dr NW
Huntsville, AL 35806-1710

Mailing address

231 Brighton Park Way
Madison, AL 35756-4931
Phone (205) 370-9430

Other practice location 1

2165 Winchester Rd NE
Huntsville, AL 35811-9198
Phone (256) 716-6769

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20251216003993 AL Part B Supplier - Clinic/Group Practice 3173018298 Receives reassigned benefits from 1 practitioner
Practice locations: Huntsville, AL

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1739750400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1739750400000",
    "number": "1356146013",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "231 BRIGHTON PARK WAY",
            "city": "MADISON",
            "state": "AL",
            "postal_code": "357564931",
            "telephone_number": "205-370-9430"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6140A UNIVERSITY DR NW",
            "city": "HUNTSVILLE",
            "state": "AL",
            "postal_code": "358061710",
            "telephone_number": "256-837-5642",
            "fax_number": "256-803-2384"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2165 Winchester Rd NE",
            "address_purpose": "LOCATION",
            "city": "Huntsville",
            "state": "AL",
            "postal_code": "358119198",
            "country_code": "US",
            "telephone_number": "256-716-6769",
            "fax_number": "256-852-9660",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "LEGACY EYE CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-02-17",
        "last_updated": "2025-02-17",
        "certification_date": "2025-02-17",
        "status": "A",
        "authorized_official_last_name": "MARBUARY",
        "authorized_official_first_name": "LATISHA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "205-370-9430",
        "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 Huntsville, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2025; 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.