NPIMap

Organization Active NPI

Mountain State Eye Center

  • Optometrist
  • Keyser, WV
National Provider Identifier
1679627558
Registry record updated Apr 5, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
897-D Issued in WV
Legal business name
MOUNTAIN STATE EYE CENTER
Practice address
RR 3 Box 3300
Keyser, WV 26726-9481
Phone
(304) 788-7800
NPI assigned
Jan 22, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 5, 2012

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

Authorized official

Name
Stacy K Rapson
Title
Administrator
Phone
(301) 722-6480

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 897-D WV Primary

Addresses

Primary practice location

RR 3 Box 3300
Keyser, WV 26726-9481

Mailing address

RR 3 Box 3300
Keyser, WV 26726-9481
Phone (304) 788-7800

Other identifiers 1

IdentifierTypeStateIssuer
0149776000MedicaidWV

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1169424000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1333584000000",
    "number": "1679627558",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "RR 3 BOX 3300",
            "city": "KEYSER",
            "state": "WV",
            "postal_code": "267269481",
            "telephone_number": "304-788-7800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "RR 3 BOX 3300",
            "city": "KEYSER",
            "state": "WV",
            "postal_code": "267269481",
            "telephone_number": "304-788-7800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOUNTAIN STATE EYE CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-22",
        "last_updated": "2012-04-05",
        "status": "A",
        "authorized_official_last_name": "RAPSON",
        "authorized_official_first_name": "STACY",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "301-722-6480"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "WV",
            "license": "897-D",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0149776000",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Keyser, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2012; 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.