NPIMap

Organization Active NPI

Abba Eye Care PC

  • Optometrist
  • Lamar, CO
National Provider Identifier
1811336282
Registry record updated Jan 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
ABBA EYE CARE PC
Practice address
1500 S Main St
Lamar, CO 81052-3824
Phone
(719) 336-0417
Fax
(719) 336-0415
NPI assigned
Jun 19, 2013
Last updated
Jan 11, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 11, 2021

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

Authorized official

Name
Dr. Marcus John Meyer, ODNPI 1114927464
Title
Owner
Phone
(719) 219-3819

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X Primary

Addresses

Primary practice location

1500 S Main St
Lamar, CO 81052-3824

Mailing address

1200 E Campbell Rd Ste 108
Richardson, TX 75081-1963
Phone (314) 741-8183

Other identifiers 1

IdentifierTypeStateIssuer
04015491MedicaidCO

National Provider Directory

National Provider Directory
Tax ID family
Abba Eye Care PC7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

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

Practitioners & affiliated clinicians

Practitioners 2

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": "1371600000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1610323200000",
    "number": "1811336282",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 E CAMPBELL RD STE 108",
            "city": "RICHARDSON",
            "state": "TX",
            "postal_code": "750811963",
            "telephone_number": "314-741-8183",
            "fax_number": "719-219-0411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 S MAIN ST",
            "city": "LAMAR",
            "state": "CO",
            "postal_code": "810523824",
            "telephone_number": "719-336-0417",
            "fax_number": "719-336-0415"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ABBA EYE CARE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-06-19",
        "last_updated": "2021-01-11",
        "certification_date": "2021-01-11",
        "status": "A",
        "authorized_official_last_name": "MEYER",
        "authorized_official_first_name": "MARCUS",
        "authorized_official_middle_name": "JOHN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "719-219-3819",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "04015491",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lamar, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2021; 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.