Community Vision Center Mossco Inc Dr Randy Wayne Moss OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

2140 Issued in AR

Legal business name

COMMUNITY VISION CENTER MOSSCO INC DR RANDY WAYNE MOSS OD

Doing business as

Community Vision Center

Practice address

109 WP Malone
Arkadelphia, AR 71923

Phone

(870) 246-6877

Fax

(870) 245-0088

NPI assigned

Oct 16, 2006

Last updated

Dec 27, 2007By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Randy Wayne Moss, OD

Title

Optometrist Owner

Phone

(870) 246-6877

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Community Vision Center Doing business as

Locations

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

{
    "created_epoch": "1160956800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1198713600000",
    "number": "1447330659",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "109 WP MALONE",
            "city": "ARKADELPHIA",
            "state": "AR",
            "postal_code": "71923",
            "telephone_number": "870-246-6877",
            "fax_number": "870-245-0088"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "109 WP MALONE",
            "city": "ARKADELPHIA",
            "state": "AR",
            "postal_code": "71923",
            "telephone_number": "870-246-6877",
            "fax_number": "870-245-0088"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY VISION CENTER MOSSCO INC DR RANDY WAYNE MOSS OD",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-16",
        "last_updated": "2007-12-27",
        "status": "A",
        "authorized_official_last_name": "MOSS",
        "authorized_official_first_name": "RANDY",
        "authorized_official_middle_name": "WAYNE",
        "authorized_official_title_or_position": "OPTOMETRIST OWNER",
        "authorized_official_telephone_number": "870-246-6877",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "AR",
            "license": "2140",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "48222",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Community Vision Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Optometrist in Arkadelphia, AR
• Providers in Arkadelphia, AR by specialty
• Optometrist in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 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.

Verify at the official NPI Registry.