Mobile Bay Vision, LLC
Organization Active NPI Optometrist · Semmes, AL
NPI 1457745408 · NPPES record last updated Jun 15, 2018
Key facts
- NPI
- 1457745408
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Optometrist 152W00000X
- License
- SD-27-TA-989 (AL)
- Legal business name
- MOBILE BAY VISION, LLC
- Practice address
- 1651 Schillinger Rd N
Semmes, AL 36575 - Phone
- (251) 706-7960
- Fax
- (251) 375-0444
- NPI assigned
- Mar 26, 2015
- Organization subpart
- No
Authorized official
- Name
- Brook Griffin
- Title
- Office Manager
- Phone
- (251) 301-9690
Other NPIs on the same Medicare enrollment 1
Practitioners 2
-
Sierra M. Perry, O.D.
-
Curtis Reed, O.D.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in AL
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20150625000988 | AL | Part B Supplier - Clinic/Group Practice | 0143531558 |
Receives reassigned benefits from 2 practitioners 1 other NPI on this enrollment Practice locations: Mobile, AL |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist |
152W00000X | SD-27-TA-989 | AL | Yes |
Addresses
Primary practice location
1651 Schillinger Rd N
Semmes, AL 36575
Mailing address
1651 Schillinger Rd N
Semmes, AL 36575-7409
Phone (251) 706-7960
Other providers in Semmes, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 15, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.