Organization Active NPI

Pro Eyes Optometry Associates LLC

  • Optometrist
  • Huntington, WV
National Provider Identifier
1467649970
Registry record updated Feb 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
WV740D Issued in WV
Legal business name
PRO EYES OPTOMETRY ASSOCIATES LLC
Practice address
3333 US Route 60
Huntington, WV 25705-2838
Phone
(304) 522-2551
NPI assigned
Sep 28, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 28, 2023

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

Authorized official

Name
Mark C Brown, OD
Title
Owner
Phone
(304) 522-2551

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X WV740D WV Primary

Addresses

Primary practice location

3333 US Route 60
Huntington, WV 25705-2838

Mailing address

3333 US Route 60
Huntington, WV 25705-2838
Phone (304) 522-2551

Other identifiers 2

IdentifierTypeStateIssuer
0150722000MedicaidWV
000101835OtherWVBCBS

National Provider Directory

National Provider Directory

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

NPI Registry JSON

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

{
    "created_epoch": "1190937600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1677542400000",
    "number": "1467649970",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3333 US ROUTE 60",
            "city": "HUNTINGTON",
            "state": "WV",
            "postal_code": "257052838",
            "telephone_number": "304-522-2551"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3333 US ROUTE 60",
            "city": "HUNTINGTON",
            "state": "WV",
            "postal_code": "257052838",
            "telephone_number": "304-522-2551"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRO EYES OPTOMETRY ASSOCIATES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-28",
        "last_updated": "2023-02-28",
        "certification_date": "2023-02-28",
        "status": "A",
        "authorized_official_last_name": "BROWN",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "304-522-2551",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "WV",
            "license": "WV740D",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0150722000",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "000101835",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Huntington, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2023; 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.