Mississippi Eyecare Associates of Byram, PLLC.

Primary specialty

OptometristTaxonomy code 152W00000X

License

783 Issued in MS

Legal business name

MISSISSIPPI EYECARE ASSOCIATES OF BYRAM, PLLC.

Practice address

7118B S Siwell Rd
Byram, MS 39272-8744

Phone

(601) 398-3000

Fax

(601) 398-3002

NPI assigned

Jul 22, 2015

Organization subpart

No

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

Authorized official

Name

Christopher Terrell Bullin, O.D.

Title

Owner/ Provider

Phone

(601) 366-9020

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MS

Enrollment records 1

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Mississippi Eye Care Associates of Jackson, PLLC

  • Optometrist
  • Jackson, MS
  • NPI 1366697799

  O20090324000450

  Same enrollment

Locations

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

{
    "created_epoch": "1437523200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1464912000000",
    "number": "1427433200",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "404 RIVERWIND DR",
            "address_2": "STE. B-1",
            "city": "PEARL",
            "state": "MS",
            "postal_code": "392085900",
            "telephone_number": "601-398-3000",
            "fax_number": "601-398-3002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7118B S SIWELL RD",
            "city": "BYRAM",
            "state": "MS",
            "postal_code": "392728744",
            "telephone_number": "601-398-3000",
            "fax_number": "601-398-3002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MISSISSIPPI EYECARE ASSOCIATES OF BYRAM, PLLC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-07-22",
        "last_updated": "2016-06-03",
        "status": "A",
        "authorized_official_last_name": "BULLIN",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_middle_name": "TERRELL",
        "authorized_official_title_or_position": "OWNER/ PROVIDER",
        "authorized_official_telephone_number": "601-366-9020",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "MS",
            "license": "783",
            "primary": true
        },
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": "MS",
            "license": "783",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "783",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kontessa McClendon, M.S., CCC-SLP
• Kelly Marie McKee, MPT
• Mea Primary Care Plus, LLC
• Medical Foundation of Central Mississippi, Inc.
• Medicomp, Inc
• Mississippi Primary Care Ms
• Cheryl Moreland, PH.D.
• Hoby Mullins
• New Life Counseling and Consulting Services
• Tiffany V Ngo, PHARMD

• Optometrist in Byram, MS
• Providers in Byram, MS by specialty
• Optometrist in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2016; 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.