Organization Active NPI

John a Carter Jr OD PC

Doing business as Bonham Optical

  • Optometrist
  • Bonham, TX
National Provider Identifier
1740638170
Registry record updated May 26, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
5381TG Issued in TX
Legal business name
JOHN A CARTER JR OD PC
Doing business as
Bonham Optical
Practice address
1230 N Center St
Bonham, TX 75418-3016
Phone
(903) 583-8930
Fax
(903) 583-8138
NPI assigned
May 26, 2016
Last updated
May 26, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 26, 2016

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

Authorized official

Name
Mr. Levi Malone, BS
Title
Office Manager
Phone
(903) 583-8930

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 5381TG TX Primary

Addresses

Primary practice location

1230 N Center St
Bonham, TX 75418-3016

Mailing address

1230 N Center St
Bonham, TX 75418-3016
Phone (903) 583-8930

Other names 1

  • Bonham Optical Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160620001798 TX Part B Supplier - Clinic/Group Practice 7911298161 Receives reassigned benefits from 1 practitioner
Practice locations: Bonham, TX

National Provider Directory

National Provider Directory
Tax ID family
Bonham Optical2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1230 N Center St
Bonham, TX 75418
Phone (903) 583-8930

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1464220800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1464220800000",
    "number": "1740638170",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1230 N CENTER ST",
            "city": "BONHAM",
            "state": "TX",
            "postal_code": "754183016",
            "telephone_number": "903-583-8930",
            "fax_number": "903-583-8138"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1230 N CENTER ST",
            "city": "BONHAM",
            "state": "TX",
            "postal_code": "754183016",
            "telephone_number": "903-583-8930",
            "fax_number": "903-583-8138"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOHN A CARTER JR OD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-05-26",
        "last_updated": "2016-05-26",
        "status": "A",
        "authorized_official_last_name": "MALONE",
        "authorized_official_first_name": "LEVI",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "903-583-8930",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "BS"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "5381TG",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bonham Optical",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bonham, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 2016; 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.