Organization Active NPI

Martinsville Family Eye Care Center Inc.

  • Optometrist
  • Martinsville, IN
National Provider Identifier
1639454556
Registry record updated Dec 21, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
MARTINSVILLE FAMILY EYE CARE CENTER INC.
Practice address
1089 E Morgan St
Martinsville, IN 46151-1744
Phone
(765) 342-2050
Fax
(765) 342-5899
NPI assigned
Oct 12, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 21, 2011

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

Authorized official

Name
Dr. Michael L. O'Neal, O.D.NPI 1366450108
Title
Owner/President
Phone
(765) 342-2050

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X Primary

Addresses

Primary practice location

1089 E Morgan St
Martinsville, IN 46151-1744

Mailing address

1089 E Morgan St
Martinsville, IN 46151-1744
Phone (765) 342-2050

Other identifiers 1

IdentifierTypeStateIssuer
100186570MedicaidIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20111028000191 IN Part B Supplier - Clinic/Group Practice 5890814156 Receives reassigned benefits from 1 practitioner
Practice locations: Martinsville, IN

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1318377600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1324425600000",
    "number": "1639454556",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1089 E MORGAN ST",
            "city": "MARTINSVILLE",
            "state": "IN",
            "postal_code": "461511744",
            "telephone_number": "765-342-2050",
            "fax_number": "765-342-5899"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1089 E MORGAN ST",
            "city": "MARTINSVILLE",
            "state": "IN",
            "postal_code": "461511744",
            "telephone_number": "765-342-2050",
            "fax_number": "765-342-5899"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARTINSVILLE FAMILY EYE CARE CENTER INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-10-12",
        "last_updated": "2011-12-21",
        "status": "A",
        "authorized_official_last_name": "O'NEAL",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "765-342-2050",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100186570",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Martinsville, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2011; 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.