Optical Center

Primary specialty

OpticianTaxonomy code 156FX1800X

Legal business name

OPTICAL CENTER

Practice address

506 Larcher Blvd BLDG 2306
Keesler Afb, MS 39534-2342

Phone

(228) 435-4418

Fax

(228) 432-2324

NPI assigned

Mar 30, 2010

Organization subpart

Yes

Parent organization

NATIONAL VISION, INC.As reported in NPPES

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

Authorized official

Name

Susan Edick

Title

MC Assistant

Phone

(678) 892-3774

Specialties & licenses 1

Addresses

Tax ID family

Wal Mart Vision Ctr 2141,614 organizations share this tax ID, including this one

Part of

Wal Mart Vision Ctr 214

Organizations with this tax ID in the same state 1

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

• National Vision, Inc.

  • Optician
  • Columbus, MS
  • NPI 1427505742
  NPD tax ID

Locations

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• National Vision, Inc.

  • Optician
  • Columbus, MS
  • NPI 1427505742
  NPPES parent name

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

{
    "created_epoch": "1269907200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1269907200000",
    "number": "1548585763",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "296 GRAYSON HWY",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300465737",
            "telephone_number": "770-822-3600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "506 LARCHER BLVD BLDG 2306",
            "city": "KEESLER AFB",
            "state": "MS",
            "postal_code": "395342342",
            "telephone_number": "228-435-4418",
            "fax_number": "228-432-2324"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OPTICAL CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "NATIONAL VISION, INC.",
        "enumeration_date": "2010-03-30",
        "last_updated": "2010-03-30",
        "status": "A",
        "authorized_official_last_name": "EDICK",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_title_or_position": "MC ASSISTANT",
        "authorized_official_telephone_number": "678-892-3774"
    },
    "taxonomies": [
        {
            "code": "156FX1800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Technician/Technologist, Optician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jacob Nguyen, DO
• Jennifer Ann Nicholson, LCSW
• Brent Eugene Nikolaus, D.D.S.
• Wendy Faviola Oliver, MSW,LCSW-A
• Verity Oltjenbruns, DO
• Carroll Atkins Palmore Jr., DMD
• Breanne Parets
• Robert C. Perryman, PHYSICIAN ASSISTANT
• Julie Petsche
• Dat Van Phan, DO

• Optician in Keesler Afb, MS
• Providers in Keesler Afb, MS by specialty
• Optician in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2010; 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.