NPIMap

Organization Active NPI

Riolan Marbun

  • Optometrist
  • Nashville, TN
National Provider Identifier
1871627729
Registry record updated Feb 17, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2354 Issued in TN
Legal business name
RIOLAN MARBUN
Practice address
800 Brent Glen PT
Nashville, TN 37211-7200
Phone
(615) 604-6101
NPI assigned
Mar 15, 2007
Last updated
Feb 17, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 17, 2009

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

Authorized official

Name
Riolan J Marbun, ODNPI 1053476788
Title
Optometrist
Phone
(252) 985-1371

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
Optometrist 152W00000X 2354 TN Primary

Addresses

Primary practice location

800 Brent Glen PT
Nashville, TN 37211-7200

Mailing address

PO Box 7756
Rocky Mount, NC 27804-0756
Phone (252) 985-1371

Other identifiers 5

IdentifierTypeStateIssuer
35900201MedicaidTN
35900202OtherTNMEDICARE GROUP #
4146608OtherTNTENNCARE SELECT PROV #
4146608OtherTNBCBS PROVIDER #
35900202OtherTNMEDICAID GROUP #

National Provider Directory

National Provider Directory

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": "1173916800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1234828800000",
    "number": "1871627729",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7756",
            "city": "ROCKY MOUNT",
            "state": "NC",
            "postal_code": "278040756",
            "telephone_number": "252-985-1371"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 BRENT GLEN PT",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372117200",
            "telephone_number": "615-604-6101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RIOLAN MARBUN",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-15",
        "last_updated": "2009-02-17",
        "status": "A",
        "authorized_official_last_name": "MARBUN",
        "authorized_official_first_name": "RIOLAN",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OPTOMETRIST",
        "authorized_official_telephone_number": "252-985-1371",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TN",
            "license": "2354",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "35900201",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP #",
            "identifier": "35900202",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TENNCARE SELECT PROV #",
            "identifier": "4146608",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PROVIDER #",
            "identifier": "4146608",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID GROUP #",
            "identifier": "35900202",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Nashville, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2009; 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.