Premier Ophthalmology, PLC

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

0101232988 Issued in VA

Legal business name

PREMIER OPHTHALMOLOGY, PLC

Practice address

477 Viking Dr
Suite 110
Virginia Beach, VA 23452-7349

Phone

(757) 340-8383

NPI assigned

Aug 24, 2007

Organization subpart

No

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

Authorized official

Name

Mark Pavilack, M.D.NPI 1245238096

Title

Owner

Phone

(757) 340-8383

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

Practitioners 1

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

• Mark A Pavilack, MD

  • Ophthalmology Physician
  • Portsmouth, VA
  • NPI 1245238096
  NPD (past) Authorized official

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

{
    "created_epoch": "1187913600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1187913600000",
    "number": "1568655389",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "477 VIKING DR",
            "address_2": "SUITE 110",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234527349",
            "telephone_number": "757-340-8383"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "477 VIKING DR",
            "address_2": "SUITE 110",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234527349",
            "telephone_number": "757-340-8383"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIER OPHTHALMOLOGY, PLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-24",
        "last_updated": "2007-08-24",
        "status": "A",
        "authorized_official_last_name": "PAVILACK",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "757-340-8383",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": "VA",
            "license": "0101232988",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS",
            "identifier": "437139",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS",
            "identifier": "437140",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Allysa Pray, LBA
• Jessica Prebor
• Precious Pearls LLC
• Precision Performance and Recovery LLC
• Premier Chiropractic Associates PC (Premier Health Chiropractic)
• Prepping for Perfection, LLC (P4P Behavior Healthcare)
• Debora Netzband Preputnik, M.A., CCC-SLP
• Ranisha Presbery, LCSW
• Jakeysha Tamara Prescott, CCC-SLP
• Jennifer Presnell-Ocon, PTA

• Ophthalmology Physician in Virginia Beach, VA
• Providers in Virginia Beach, VA by specialty
• Ophthalmology Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2007; 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.