Eyebis

Primary specialty

OptometristTaxonomy code 152W00000X

Legal business name

EYEBIS

Practice address

7450 Cypress Gardens Blvd
Winter Haven, FL 33884-6200

Phone

(863) 310-0329

Fax

(813) 318-0348

NPI assigned

Dec 11, 2020

Last updated

May 28, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Keion Mark, ODNPI 1962841072

Title

Managing Provider

Phone

(484) 477-2579

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Keion Mark, O.D,

  • Optometrist
  • Plant City, FL
  • NPI 1962841072
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1607644800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1716854400000",
    "number": "1649866815",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2161 E COUNTY ROAD 540A # 254",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338133794",
            "telephone_number": "484-477-2579"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7450 CYPRESS GARDENS BLVD",
            "city": "WINTER HAVEN",
            "state": "FL",
            "postal_code": "338846200",
            "telephone_number": "863-310-0329",
            "fax_number": "813-318-0348"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EYEBIS",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-12-11",
        "last_updated": "2024-05-28",
        "certification_date": "2024-05-28",
        "status": "A",
        "authorized_official_last_name": "MARK",
        "authorized_official_first_name": "KEION",
        "authorized_official_title_or_position": "MANAGING PROVIDER",
        "authorized_official_telephone_number": "484-477-2579",
        "authorized_official_credential": "OD"
    },
    "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": "019517900",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Eye Doctors Optical Outlets PA
• Eye Express (Optical at Bond Clinic)
• Eye Express, Inc.
• Eye Express, Inc.
• Eye Specialists of Mid Florida PA
• Faatz, Inc
• William Fabian, PT, DPT
• Ashley Jessica Falk, M.D.
• Nathan P Falk, MD
• Family Extended Care of Winter Haven, Inc. (The Hawthorne Inn)

• Optometrist in Winter Haven, FL
• Providers in Winter Haven, FL by specialty
• Optometrist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2024; 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.