Jesse Ben Mize III & Christie Mize PTR

Primary specialty

OptometristTaxonomy code 152W00000X

License

924-OD Issued in WV

Legal business name

JESSE BEN MIZE III & CHRISTIE MIZE PTR

Practice address

706 Washington St
Ravenswood, WV 26164-1772

Phone

(304) 273-2020

NPI assigned

May 9, 2006

Organization subpart

No

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

Authorized official

Name

Virginia E Taylor

Title

Office Manager

Phone

(304) 273-2020

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• RAVENSWOOD EYECARE Doing business as

Medicare fee-for-service enrollment

Enrolled in WV

Enrollment records 1

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Jesse Ben Mize III & Christie Mize PTR

  • Optometrist
  • Point Pleasant, WV
  • NPI 1306710488

  O20050124000146

  Same enrollment

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 5

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

• Christine R Mize, O.D.

  • Optometrist
  • Ravenswood, WV
  • NPI 1235104480
  Medicare reassignment Care Compare group NPD
• Jesse Ben Mize III, O.D.

  • Optometrist
  • Ravenswood, WV
  • NPI 1235104068
  Medicare reassignment Care Compare group NPD
• Jesse Logan Mize, OD

  • Optometrist
  • Ravenswood, WV
  • NPI 1285246546
  Medicare reassignment Care Compare group NPD
• John B. Knight, OD

  • Optometrist
  • Barboursville, WV
  • NPI 1972666030
  Medicare reassignment Care Compare group NPD (past)
• Adara Lee, OD

  • Optometrist
  • Ravenswood, WV
  • NPI 1306764337
  NPD (past)

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

{
    "created_epoch": "1147132800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1265932800000",
    "number": "1881643583",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "706 WASHINGTON ST",
            "city": "RAVENSWOOD",
            "state": "WV",
            "postal_code": "261641772",
            "telephone_number": "304-273-2020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "706 WASHINGTON ST",
            "city": "RAVENSWOOD",
            "state": "WV",
            "postal_code": "261641772",
            "telephone_number": "304-273-2020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JESSE BEN MIZE III & CHRISTIE MIZE PTR",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-09",
        "last_updated": "2010-02-12",
        "status": "A",
        "authorized_official_last_name": "TAYLOR",
        "authorized_official_first_name": "VIRGINIA",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "304-273-2020"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": "WV",
            "license": "924-OD",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001267200",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "RAVENSWOOD EYECARE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Cameron R Hord
• Carolyn Hudson
• Roselee D Hurst
• M a Zurita Hernando Ibrahim, PT
• Morgan Elizabeth Jarvis, BA
• Melissa Johnston
• Anthony Todd Keller, R.PH
• Kenneth Lee Kelps
• Ruby Dianne Kibble
• Laura Elizabeth Kirk

• Optometrist in Ravenswood, WV
• Providers in Ravenswood, WV by specialty
• Optometrist in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.