Active NPI
Tracey Lynn Manbeck
- Optometrist
- Columbus, OH
National Provider Identifier
1720298227
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 5595 T2509
- Practice address
- 1599 W Lane Ave
Columbus, OH 43221-3924 - Phone
- (614) 486-9354
- Fax
- (614) 486-8036
- NPI assigned
- May 23, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 5595 T2509 | OH | Primary |
Addresses
Primary practice location
1599 W Lane Ave
Columbus, OH 43221-3924
Mailing address
6905 Margarum BND
New Albany, OH 43054-7049
Phone (614) 939-0990
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5595 T2509 | OH | MD | Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179878400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1720298227",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6905 MARGARUM BND",
"city": "NEW ALBANY",
"state": "OH",
"postal_code": "430547049",
"telephone_number": "614-939-0990"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1599 W LANE AVE",
"city": "COLUMBUS",
"state": "OH",
"postal_code": "432213924",
"telephone_number": "614-486-9354",
"fax_number": "614-486-8036"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MANBECK",
"first_name": "TRACEY",
"middle_name": "LYNN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-05-23",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "OH",
"license": "5595 T2509",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Columbus, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.