Individual provider Active NPI

Robert Clayton Maynor Jr., MD

  • Ophthalmology Physician
  • Huntsville, AL
National Provider Identifier
1497704175
Registry record updated Oct 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
00005458 Issued in AL
Practice address
3501 Memorial Pkwy SW Ste 200
Huntsville, AL 35801-6901
Phone
(256) 533-0315
NPI assigned
May 9, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 12, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X 00005458 AL Primary

Addresses

Primary practice location

3501 Memorial Pkwy SW Ste 200
Huntsville, AL 35801-6901

Mailing address

3501 Memorial Pkwy SW Ste 200
Huntsville, AL 35801-6901
Phone (256) 533-0315

Other identifiers 1

IdentifierTypeStateIssuer
529904260-8936MedicaidAL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130515000444 AL Practitioner - Ophthalmology 5890702211 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
00005458ALMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Maynor & Mitchell Eye Center PC Ophthalmology CurrentSince May 3, 1999 Accepting new patients
Maynor & Mitchell Optical Shop LLC PastSince May 3, 1999 Accepting new patients

Locations

3501 Memorial Pkwy SW
Ste 200
Huntsville, AL 35801
Phone (256) 533-0315

Interoperability endpoints

  • Direct secure messaging: rmaynor@mmec.intellechartdirect.net

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1147132800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728691200000",
    "number": "1497704175",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3501 MEMORIAL PKWY SW STE 200",
            "city": "HUNTSVILLE",
            "state": "AL",
            "postal_code": "358016901",
            "telephone_number": "256-533-0315"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3501 MEMORIAL PKWY SW STE 200",
            "city": "HUNTSVILLE",
            "state": "AL",
            "postal_code": "358016901",
            "telephone_number": "256-533-0315"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAYNOR",
        "first_name": "ROBERT",
        "middle_name": "CLAYTON",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-09",
        "last_updated": "2024-10-12",
        "certification_date": "2024-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "AL",
            "license": "00005458",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "529904260-8936",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Huntsville, AL

Sources for this page

Verify at the official NPI Registry.