Individual provider Active NPI

Megan Leigh Moll, O.D.

  • Optometrist
  • Jonesboro, AR
National Provider Identifier
1386877405
Registry record updated Oct 10, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2628 Issued in AR
Practice address
3705 E Johnson Ave
Jonesboro, AR 72401-1858
Phone
(870) 336-2452
NPI assigned
Aug 24, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 10, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2628 AR Primary

Addresses

Primary practice location

3705 E Johnson Ave
Jonesboro, AR 72401-1858

Mailing address

3705 E Johnson Ave
Jonesboro, AR 72401-1858
Phone (870) 336-2452

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20091007000326 AR Practitioner - Optometry 7719023621 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern College of Optometry, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hilltop Eyecare PLLCGroup PAC ID 1153572946, 3 clinicians

Practice addresses (Care Compare)

3705 E Johnson Ave
Jonesboro, AR 72405-1858
Phone (870) 336-2452

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery16

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2628ARMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Hilltop Eyecare PLLC Optometrist CurrentSince Sep 2, 2012 Accepting new patients
Vision Therapy Center of Jonesboro, P.L.L.C. CurrentSince Nov 6, 2014 Accepting new patients

Locations

3705 E Johnson Ave
Jonesboro, AR 72405
Phone (870) 336-2452

3705 E Johnson Ave
#B
Jonesboro, AR 72405
Phone (870) 336-0387

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1251072000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1349827200000",
    "number": "1386877405",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3705 E JOHNSON AVE",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "724011858",
            "telephone_number": "870-336-2452"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3705 E JOHNSON AVE",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "724011858",
            "telephone_number": "870-336-2452"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOLL",
        "first_name": "MEGAN",
        "middle_name": "LEIGH",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-08-24",
        "last_updated": "2012-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "AR",
            "license": "2628",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jonesboro, AR

Sources for this page

Verify at the official NPI Registry.