Martinsville Vision Clinic PC

Primary specialty

OptometristTaxonomy code 152W00000X

License

18002989B Issued in IN

Legal business name

MARTINSVILLE VISION CLINIC PC

Practice address

219 E Washington St
Martinsville, IN 46151-1554

Phone

(765) 342-6654

Fax

(765) 342-0418

NPI assigned

Sep 22, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Aaron B Cunningham, ODNPI 1871592535

Title

President/Owner

Phone

(765) 342-6654

Specialties & licenses 3

Addresses

Other identifiers 7

Medicare fee-for-service enrollment

Enrolled in IN

Enrollment records 1

Locations

Practitioners 2

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

• Aaron Booth Cunningham, OD

  • Optometrist
  • Martinsville, IN
  • NPI 1871592535
  Medicare reassignment Care Compare group NPD Authorized official
• Kelly Lynne Cunningham, OD

  • Optometrist
  • Martinsville, IN
  • NPI 1881693547
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1158883200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1222905600000",
    "number": "1679673495",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "219 E WASHINGTON ST",
            "city": "MARTINSVILLE",
            "state": "IN",
            "postal_code": "461511554",
            "telephone_number": "765-342-6654",
            "fax_number": "765-342-0418"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "219 E WASHINGTON ST",
            "city": "MARTINSVILLE",
            "state": "IN",
            "postal_code": "461511554",
            "telephone_number": "765-342-6654",
            "fax_number": "765-342-0418"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARTINSVILLE VISION CLINIC PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-22",
        "last_updated": "2008-10-02",
        "status": "A",
        "authorized_official_last_name": "CUNNINGHAM",
        "authorized_official_first_name": "AARON",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "PRESIDENT/OWNER",
        "authorized_official_telephone_number": "765-342-6654",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": "IN",
            "license": "18001572B",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": "IN",
            "license": "18002989B",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": "IN",
            "license": "18003161B",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KELLY CUNNINGHAM NPI",
            "identifier": "1881693547",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200242470A",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "THEODORE REX LEGLER II NPI",
            "identifier": "1023017639",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200076560A",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200242380A",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200341850A",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AARON CUNNINGHAM NPI",
            "identifier": "1871592535",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Martinsville Family Eye Care Center Inc.
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• Martinsville Fire Department
• Martinsville Pediatric Dentistry, L.L.C.
• Martinsville Pediatric Dentistry, LLC
• Montgomery W Marvel, D.D.S.
• Taylor A McClone
• McFadden Family Dentistry, P.C.
• John Robert McFadden, DDS
• Samantha McMinn, LCSW

• Optometrist in Martinsville, IN
• Providers in Martinsville, IN by specialty
• Optometrist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2008; 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.