Mary Lee Pemberton, OD PC

Primary specialty

OptometristTaxonomy code 152W00000X

License

0618000738 Issued in VA

Legal business name

MARY LEE PEMBERTON, OD PC

Practice address

2522 Jefferson Hwy
Suite 106
Waynesboro, VA 22980-8503

Phone

(540) 946-8727

Fax

(540) 949-5526

NPI assigned

Nov 28, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Mary Lee Pemberton, O.D.NPI 1003802422

Title

President

Phone

(540) 946-8727

Specialties & licenses 1

Addresses

Other names 1

• Pemberton Eye Optometry Doing business as

Medicare fee-for-service enrollment

Enrolled in VA

Enrollment records 1

Locations

Practitioners 1

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

• Mary Lee Pemberton, O.D.

  • Optometrist
  • Waynesboro, VA
  • NPI 1003802422
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1164672000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1244764800000",
    "number": "1720154974",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2522 JEFFERSON HWY",
            "address_2": "SUITE 106",
            "city": "WAYNESBORO",
            "state": "VA",
            "postal_code": "229808503",
            "telephone_number": "540-946-8727",
            "fax_number": "540-949-5526"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2522 JEFFERSON HWY",
            "address_2": "SUITE 106",
            "city": "WAYNESBORO",
            "state": "VA",
            "postal_code": "229808503",
            "telephone_number": "540-946-8727",
            "fax_number": "540-949-5526"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARY LEE PEMBERTON, OD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-28",
        "last_updated": "2009-06-12",
        "status": "A",
        "authorized_official_last_name": "PEMBERTON",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "540-946-8727",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "VA",
            "license": "0618000738",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pemberton Eye Optometry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Elizabeth Charlotte Maneval, MS, CF-SLP
• Richard S Mansfield, DDS
• Jasmine Amber Marquez, APRN, FNP-C
• Phyllis Nicole Martin
• Andrey Marusich
• Erika Katherine Masek, LCSW
• Ayush Mathur, DDS
• Jill Marie McAninch, PHARM D
• Lacosta Maria McCall
• Karen McCauley, NP

• Optometrist in Waynesboro, VA
• Providers in Waynesboro, VA by specialty
• Optometrist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2009; 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.