NPIMap

Organization Active NPI

Picayune Eye Clinic

Doing business as Poplarville Eye Clinic

  • Optometrist
  • Poplarville, MS
National Provider Identifier
1659546802
Registry record updated Jul 16, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
559 Issued in MS
Legal business name
PICAYUNE EYE CLINIC
Doing business as
Poplarville Eye Clinic
Practice address
1249 S Main St
Poplarville, MS 39470-3313
Phone
(601) 795-0137
Fax
(601) 798-4770
NPI assigned
Apr 29, 2008
Last updated
Jul 16, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2008

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

Authorized official

Name
Lori L Blackmer, ODNPI 1760451595
Title
Owner
Phone
(601) 798-4182

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 152W00000X 559 MS Primary
OptometristGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 152W00000X 584 MS

Addresses

Primary practice location

1249 S Main St
Poplarville, MS 39470-3313

Mailing address

908 Sixth Ave
Picayune, MS 39466
Phone (601) 798-4182

Other names 1

  • Poplarville Eye Clinic Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Picayune Eye Clinic2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the 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, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1209427200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1216166400000",
    "number": "1659546802",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "908 SIXTH AVE",
            "city": "PICAYUNE",
            "state": "MS",
            "postal_code": "39466",
            "telephone_number": "601-798-4182",
            "fax_number": "601-798-4770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1249 S MAIN ST",
            "city": "POPLARVILLE",
            "state": "MS",
            "postal_code": "394703313",
            "telephone_number": "601-795-0137",
            "fax_number": "601-798-4770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PICAYUNE EYE CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-29",
        "last_updated": "2008-07-16",
        "status": "A",
        "authorized_official_last_name": "BLACKMER",
        "authorized_official_first_name": "LORI",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "601-798-4182",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": "MS",
            "license": "559",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": "MS",
            "license": "584",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Poplarville Eye Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Poplarville, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2008; 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.