Mountaineer Vision Center, PLLC

Primary specialty

OptometristTaxonomy code 152W00000X

License

663-D Issued in WV

Legal business name

MOUNTAINEER VISION CENTER, PLLC

Practice address

827 Fairmont Rd
Suite 105
Morgantown, WV 26501-3857

Phone

(304) 296-3333

Fax

(304) 296-2220

NPI assigned

Dec 2, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Mark D Robinson, ODNPI 1780671917

Title

Owner Member

Phone

(304) 296-3333

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in WV

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Mark D Robinson, OD

  • Optometrist
  • Morgantown, WV
  • NPI 1780671917
  Medicare reassignment NPD Authorized official
• Vadrevu K Raju, M.D.

  • Ophthalmology Physician
  • Morgantown, WV
  • NPI 1346248127
  Medicare reassignment

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

{
    "created_epoch": "1165017600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1312243200000",
    "number": "1467520890",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "827 FAIRMONT RD",
            "address_2": "SUITE 105",
            "city": "MORGANTOWN",
            "state": "WV",
            "postal_code": "265013857",
            "telephone_number": "304-296-3333",
            "fax_number": "304-296-2220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "827 FAIRMONT RD",
            "address_2": "SUITE 105",
            "city": "MORGANTOWN",
            "state": "WV",
            "postal_code": "265013857",
            "telephone_number": "304-296-3333",
            "fax_number": "304-296-2220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOUNTAINEER VISION CENTER, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-02",
        "last_updated": "2011-08-02",
        "status": "A",
        "authorized_official_last_name": "ROBINSON",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "OWNER MEMBER",
        "authorized_official_telephone_number": "304-296-3333",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "WV",
            "license": "663-D",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3810001261",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mountaineer Counseling
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• Mountaineer Orthodontics, PLLC
• Mountaineer Orthopedic Specialists, LLC
• Mountaineer Psychological Services, PLLC
• Mountaineer Wound Care, LLC
• Mountainstate Orthopedic Associates, Inc.
• Mountainview Services, LLC
• Dawn Moury, MSN, BSN, RN
• Bryan Mouser, MD

• Optometrist in Morgantown, WV
• Providers in Morgantown, WV by specialty
• Optometrist in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.