Organization Active NPI

Charles E McMasters Inc

  • Optometrist
  • Flowood, MS
National Provider Identifier
1407118474
Registry record updated Jun 14, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
530 Issued in MS
Legal business name
CHARLES E MCMASTERS INC
Practice address
120 Promenade Blvd
Flowood, MS 39232-8017
Phone
(601) 992-1010
Fax
(601) 992-7700
NPI assigned
Jun 14, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 14, 2012

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

Authorized official

Name
Tricia Duncan
Title
Biller
Phone
(601) 878-6945

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 530 MS Primary

Addresses

Primary practice location

120 Promenade Blvd
Flowood, MS 39232-8017

Mailing address

PO Box 3144
Ridgeland, MS 39158-3144
Phone (601) 992-1010

Other identifiers 1

IdentifierTypeStateIssuer
01538278MedicaidMS

National Provider Directory

National Provider Directory

Locations

120 Promenade Blvd
Flowood, MS 39232
Phone (601) 992-1010

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": "1339632000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1339632000000",
    "number": "1407118474",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3144",
            "city": "RIDGELAND",
            "state": "MS",
            "postal_code": "391583144",
            "telephone_number": "601-992-1010",
            "fax_number": "601-992-7700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 PROMENADE BLVD",
            "city": "FLOWOOD",
            "state": "MS",
            "postal_code": "392328017",
            "telephone_number": "601-992-1010",
            "fax_number": "601-992-7700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHARLES E MCMASTERS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-06-14",
        "last_updated": "2012-06-14",
        "status": "A",
        "authorized_official_last_name": "DUNCAN",
        "authorized_official_first_name": "TRICIA",
        "authorized_official_title_or_position": "BILLER",
        "authorized_official_telephone_number": "601-878-6945"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "MS",
            "license": "530",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01538278",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Flowood, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2012; 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.