Organization Active NPI

Optimart, Inc.

  • Optician
  • St Petersburg, FL
National Provider Identifier
1598986598
Registry record updated Sep 23, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
OpticianTaxonomy code 156FX1800X
Legal business name
OPTIMART, INC.
Practice address
4359 35TH St N
St Petersburg, FL 33714-3717
Phone
(727) 525-3959
Fax
(727) 914-8610
NPI assigned
May 1, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2020

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

Authorized official

Name
Gregory Louis Mathis
Title
Administrator
Phone
(727) 914-8615

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OpticianGroup: 193400000X SINGLE SPECIALTY GROUP 156FX1800X Primary

Addresses

Primary practice location

4359 35TH St N
St Petersburg, FL 33714-3717

Mailing address

4359 35TH St N
St Petersburg, FL 33714-3717
Phone (727) 914-8615

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1177977600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1600819200000",
    "number": "1598986598",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4359 35TH ST N",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337143717",
            "telephone_number": "727-914-8615",
            "fax_number": "727-914-8610"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4359 35TH ST N",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337143717",
            "telephone_number": "727-525-3959",
            "fax_number": "727-914-8610"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OPTIMART, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-01",
        "last_updated": "2020-09-23",
        "certification_date": "2020-09-23",
        "status": "A",
        "authorized_official_last_name": "MATHIS",
        "authorized_official_first_name": "GREGORY",
        "authorized_official_middle_name": "LOUIS",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "727-914-8615"
    },
    "taxonomies": [
        {
            "code": "156FX1800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Technician/Technologist, Optician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St Petersburg, FL

Sources for this page

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