NPIMap

Organization Active NPI

Carmichael Optical Shoppe, Inc

  • Eyewear Supplier
  • Wetumpka, AL
National Provider Identifier
1780902304
Registry record updated Jul 31, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Eyewear SupplierTaxonomy code 332H00000X
License
134499 Issued in AL
Legal business name
CARMICHAEL OPTICAL SHOPPE, INC
Practice address
8007 US Highway 231
Wetumpka, AL 36092-2062
Phone
(334) 567-9106
Fax
(334) 567-8004
NPI assigned
May 6, 2010
Organization subpart
Yes
Parent organization
CARMICHAEL OPTICAL SHOPPE, INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 31, 2015

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

Authorized official

Name
Mr. Roger R Yonker Jr.
Title
Ceo
Phone
(334) 277-9111

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Eyewear Supplier 332H00000X 134499 AL Primary

Addresses

Primary practice location

8007 US Highway 231
Wetumpka, AL 36092-2062

Mailing address

8007 US Highway 231
Wetumpka, AL 36092-2062
Phone (334) 567-9106

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20101209001217 AL DME Supplier - Optician 4789703794 Practice locations: Wetumpka, AL

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Carmichael Optical Shoppe Inc2 organizations share this tax ID, including this one
Part of
Carmichael Optical Shoppe Inc

Other organizations with this tax ID 1

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

Locations

4255 Carmichael Ct N
Montgomery, AL 36106
Phone (334) 277-7677

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 5

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

NPI Registry JSON

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

{
    "created_epoch": "1273104000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1438300800000",
    "number": "1780902304",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8007 US HIGHWAY 231",
            "city": "WETUMPKA",
            "state": "AL",
            "postal_code": "360922062",
            "telephone_number": "334-567-9106",
            "fax_number": "334-567-8004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8007 US HIGHWAY 231",
            "city": "WETUMPKA",
            "state": "AL",
            "postal_code": "360922062",
            "telephone_number": "334-567-9106",
            "fax_number": "334-567-8004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CARMICHAEL OPTICAL SHOPPE, INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CARMICHAEL OPTICAL SHOPPE, INC",
        "enumeration_date": "2010-05-06",
        "last_updated": "2015-07-31",
        "status": "A",
        "authorized_official_last_name": "YONKER",
        "authorized_official_first_name": "ROGER",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "334-277-9111",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": "AL",
            "license": "134499",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wetumpka, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2015; 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.