Organization Active NPI

Lighthouse of Pinellas Inc

  • Low Vision Rehabilitation Optometrist
  • Largo, FL
National Provider Identifier
1801858071
Registry record updated Jun 9, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Low Vision Rehabilitation OptometristTaxonomy code 152WL0500X
Legal business name
LIGHTHOUSE OF PINELLAS INC
Practice address
6925 112TH Cir
Largo, FL 33773-5200
Phone
(727) 544-4433
Fax
(727) 544-5511
NPI assigned
Apr 4, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2016

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

Authorized official

Name
Mr. Daniel T Mann
Title
President/Ceo
Phone
(727) 544-4433

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Low Vision Rehabilitation OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152WL0500X Primary

Addresses

Primary practice location

6925 112TH Cir
Largo, FL 33773-5200

Mailing address

6925 112TH Cir N
Largo, FL 33773-5520
Phone (727) 544-4433

Other identifiers 3

IdentifierTypeStateIssuer
880145200MedicaidFL
880147900MedicaidFL
882356100MedicaidFL

National Provider Directory

National Provider Directory

Locations

6925 112th Cir
Ste 101
Largo, FL 33773

6925 112th Cir
Ste 103
Largo, FL 33773
Phone (727) 544-4433

6925 112th Cir
Largo, FL 33773
Phone (727) 544-4433

Practitioners & affiliated clinicians

Practitioners 2

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": "1144108800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1465430400000",
    "number": "1801858071",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6925 112TH CIR N",
            "city": "LARGO",
            "state": "FL",
            "postal_code": "337735520",
            "telephone_number": "727-544-4433",
            "fax_number": "727-544-5511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6925 112TH CIR",
            "city": "LARGO",
            "state": "FL",
            "postal_code": "337735200",
            "telephone_number": "727-544-4433",
            "fax_number": "727-544-5511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIGHTHOUSE OF PINELLAS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-04",
        "last_updated": "2016-06-09",
        "status": "A",
        "authorized_official_last_name": "MANN",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "727-544-4433",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "152WL0500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist, Low Vision Rehabilitation",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "880145200",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "880147900",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "882356100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Largo, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.