Active NPI
Michael A Langevin, OD
- Optometrist
- Mountain Home, AR
National Provider Identifier
1740400472
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 2264
- Practice address
- 65 Wal Mart Dr
Suite 8
Mountain Home, AR 72653-6784 - Phone
- (870) 492-2208
- Fax
- (870) 492-7099
- NPI assigned
- Apr 26, 2007
- Sex
- Male
- 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 | 2264 | AR | Primary |
Addresses
Primary practice location
65 Wal Mart Dr
Suite 8
Mountain Home, AR 72653-6784
Mailing address
65 Wal Mart Dr
Suite 8
Mountain Home, AR 72653-6784
Phone (870) 492-2208
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 199849722 | Medicaid | AR |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in AR
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Optometry
- Education
- Southern California College of Optometry, 1979
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
65 Wal Mart Dr
Suite 8
Mountain Home, AR 72653-6062
Phone (870) 492-2136
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2264 | AR | MD | Registered Dietitian |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Optometrist
- Mountain Home, AR
- NPI 1871931006
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1177545600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1714953600000",
"number": "1740400472",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "65 WAL MART DR",
"address_2": "SUITE 8",
"city": "MOUNTAIN HOME",
"state": "AR",
"postal_code": "726536784",
"telephone_number": "870-492-2208",
"fax_number": "870-492-7099"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "65 WAL MART DR",
"address_2": "SUITE 8",
"city": "MOUNTAIN HOME",
"state": "AR",
"postal_code": "726536784",
"telephone_number": "870-492-2208",
"fax_number": "870-492-7099"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LANGEVIN",
"first_name": "MICHAEL",
"middle_name": "A",
"name_prefix": "Dr.",
"credential": "OD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-04-26",
"last_updated": "2024-05-06",
"certification_date": "2024-05-06",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "AR",
"license": "2264",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "199849722",
"state": "AR"
}
],
"endpoints": [],
"other_names": []
}Other providers in Mountain Home, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.