Mary M Futch OD PA

Primary specialty

OptometristTaxonomy code 152W00000X

License

OPC 2517 Issued in FL

Legal business name

MARY M FUTCH OD PA

Doing business as

Baker Vision Care

Practice address

31 S 6TH St
Macclenny, FL 32063-2311

Phone

(904) 259-6259

Fax

(904) 259-3436

NPI assigned

Apr 11, 2012

Last updated

Aug 6, 2012By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Mary Martha Futch, ODNPI 1356361208

Title

President

Phone

(904) 259-6259

Specialties & licenses 1

Addresses

Other identifiers 5

Other names 1

• Baker Vision Care Doing business as

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Mary Martha Futch, O.D.

  • Optometrist
  • Macclenny, FL
  • NPI 1356361208
  Medicare reassignment NPD Authorized official
• Flora Chen Poveda, O.D.

  • Optometrist
  • Jacksonville, FL
  • NPI 1770625899
  Medicare reassignment NPD
• Julie Lynn Owens, OD

  • Optometrist
  • Lake City, FL
  • NPI 1750364063
  NPD (past)

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

{
    "created_epoch": "1334102400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1344211200000",
    "number": "1508122854",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31 S 6TH ST",
            "city": "MACCLENNY",
            "state": "FL",
            "postal_code": "320632311",
            "telephone_number": "904-259-6259",
            "fax_number": "904-259-3436"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31 S 6TH ST",
            "city": "MACCLENNY",
            "state": "FL",
            "postal_code": "320632311",
            "telephone_number": "904-259-6259",
            "fax_number": "904-259-3436"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARY M FUTCH OD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-04-11",
        "last_updated": "2012-08-06",
        "status": "A",
        "authorized_official_last_name": "FUTCH",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "MARTHA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "904-259-6259",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC 2517",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "20312",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1356361208",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHARMACY CERTIFICATION",
            "identifier": "OC0002221",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1508122854",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "620401500",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Baker Vision Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Melissa Ludington, PHARM D.
• Taylor Lyles
• Macclenny Pharmacy Company
• Claudette M Mallory, APRN
• Margaret L. Romeo, D.M.D.,P.a.
• Shakeira S Maxwell
• Brookes McClellan, ARNP
• Steven Douglas McClintock, DDS
• Carolyn McCrary
• Wendy McDougald

• Optometrist in Macclenny, FL
• Providers in Macclenny, FL by specialty
• Optometrist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.