Individual provider Active NPI

Mallory Cranmer

  • Optometrist
  • Burke, VA
National Provider Identifier
1831500933
Registry record updated Aug 18, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
0618002858 Issued in VA
Practice address
9314 Old Keene Mill Rd Ste a
Burke, VA 22015-4284
Phone
(703) 569-3131
NPI assigned
May 12, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 18, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPT2840 GA
Optometrist 152W00000X 0618002858 VA Primary

Addresses

Primary practice location

9314 Old Keene Mill Rd Ste a
Burke, VA 22015-4284

Mailing address

9314 Old Keene Mill Rd Ste a
Burke, VA 22015-4284
Phone (703) 569-3131

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA, CO, DC3 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20141008002662 GA Practitioner - Optometry 7618197997 Reassigns benefits to 1 organization
I20181029000303 CO Practitioner - Optometry 7618197997 Reassigns benefits to 1 organization
I20200624003394 DC Practitioner - Optometry 7618197997 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Virginia Eyecare Center PCGroup PAC ID 0648332155, 6 clinicians

Practice addresses (Care Compare)

9314 Old Keene Mill Rd
Suite a
Burke, VA 22015-4284
Phone (703) 569-3131

Merit-based Incentive Payment System (MIPS)

Final score
99.8 of 100Reported as group
Quality
99.6
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery28

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OPT2840GAMDOptometrist
0618002858VAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Mark Lynn O.D. & Associates, PC CurrentSince Nov 6, 2014 Accepting new patients
Sowash Optometry Group, PC Optometrist CurrentSince Sep 1, 2018 Accepting new patients
Sowash Optometry Group PC Optometrist CurrentSince Sep 1, 2018 Accepting new patients
Virginia Eyecare Center, P.C. Optometrist CurrentSince Aug 4, 2020 Accepting new patients
Mark Lynn OD & Associates, PC Optometrist CurrentSince Nov 6, 2014 Accepting new patients
Myeyedr Optometry of Georgia, LLC Optometrist Past Accepting new patients

Locations

355 S Wadsworth Blvd
Unit D
Lakewood, CO 80226
Phone (720) 962-6906

4206 N Freeway Rd
Pueblo, CO 81008
Phone (719) 253-2538

1805 Epps Bridge Pkwy
Ste 105
Athens, GA 30606
Phone (706) 352-2282

2929 Turner Hill Rd
Ste 2625
Lithonia, GA 30038
Phone (770) 482-5050

9314 Old Keene Mill Rd
Ste A
Burke, VA 22015
Phone (703) 569-3131

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1399852800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597708800000",
    "number": "1831500933",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9314 OLD KEENE MILL RD STE A",
            "city": "BURKE",
            "state": "VA",
            "postal_code": "220154284",
            "telephone_number": "703-569-3131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9314 OLD KEENE MILL RD STE A",
            "city": "BURKE",
            "state": "VA",
            "postal_code": "220154284",
            "telephone_number": "703-569-3131"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRANMER",
        "first_name": "MALLORY",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-05-12",
        "last_updated": "2020-08-18",
        "certification_date": "2020-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "GA",
            "license": "OPT2840",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "VA",
            "license": "0618002858",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Burke, VA

Sources for this page

Verify at the official NPI Registry.