NPIMap

Organization Active NPI

Mallard Eye Care, LLC

  • Optometrist
  • Columbia, TN
National Provider Identifier
1487010674
Registry record updated Jan 23, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2955 Issued in TN
Legal business name
MALLARD EYE CARE, LLC
Practice address
2200 Brookmeade Dr
Columbia, TN 38401-3994
Phone
(931) 381-3900
NPI assigned
Jan 5, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2020

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

Authorized official

Name
Dr. Christopher Mallard, ODNPI 1255646907
Title
Owner
Phone
(615) 302-4477

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 2955 TN Primary

Addresses

Primary practice location

2200 Brookmeade Dr
Columbia, TN 38401-3994

Mailing address

2200 Brookmeade Dr
Columbia, TN 38401-3994
Phone (931) 381-3900

Other names 1

  • Mallard Eye Care Columbia Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Mallard Eye Care2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1451952000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1579737600000",
    "number": "1487010674",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2200 BROOKMEADE DR",
            "city": "COLUMBIA",
            "state": "TN",
            "postal_code": "384013994",
            "telephone_number": "931-381-3900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2200 BROOKMEADE DR",
            "city": "COLUMBIA",
            "state": "TN",
            "postal_code": "384013994",
            "telephone_number": "931-381-3900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MALLARD EYE CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-01-05",
        "last_updated": "2020-01-23",
        "certification_date": "2020-01-23",
        "status": "A",
        "authorized_official_last_name": "MALLARD",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "615-302-4477",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "TN",
            "license": "2955",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mallard Eye Care Columbia",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Mallard Eye Care Columbia",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Columbia, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2020; 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.