Active NPI
Justin Mayer, OD
- Optometrist
- Fort Worth, TX
National Provider Identifier
1619793064
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 11307
- Practice address
- 2600 W 7TH St Ste 145
Fort Worth, TX 76107-9301 - Phone
- (210) 683-8099
- NPI assigned
- Dec 2, 2024
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 11307 | TX | Primary |
Addresses
Primary practice location
2600 W 7TH St Ste 145
Fort Worth, TX 76107-9301
Mailing address
1015 NW 38TH Ave
Cape Coral, FL 33993-9316
Phone (210) 683-8099
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11307 | TX | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1733097600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1733443200000",
"number": "1619793064",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1015 NW 38TH AVE",
"city": "CAPE CORAL",
"state": "FL",
"postal_code": "339939316",
"telephone_number": "210-683-8099"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2600 W 7TH ST STE 145",
"city": "FORT WORTH",
"state": "TX",
"postal_code": "761079301",
"telephone_number": "210-683-8099"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MAYER",
"first_name": "JUSTIN",
"name_prefix": "Dr.",
"credential": "OD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2024-12-02",
"last_updated": "2024-12-06",
"certification_date": "2024-12-06",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "TX",
"license": "11307",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Worth, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.