Organization Active NPI

McConkey Eye Care LLC

  • Optometrist
  • Baltimore, MD
National Provider Identifier
1902596224
Registry record updated May 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
MCCONKEY EYE CARE LLC
Practice address
4425 Fitch Ave Ste 120
Baltimore, MD 21236-3927
Phone
(410) 459-5320
NPI assigned
May 10, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 23, 2024

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

Authorized official

Name
Whitney McConkey, ODNPI 1275990145
Title
Owner
Phone
(410) 459-5320

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

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

Addresses

Primary practice location

4425 Fitch Ave Ste 120
Baltimore, MD 21236-3927

Mailing address

1420 Saratoga Dr
Bel Air, MD 21014-5516
Phone (410) 459-5320

Other practice location 1

1128 Baldwin Mill Rd
Jarrettsville, MD 21084-1914
Phone (443) 453-5444

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20230616000590 MD Part B Supplier - Clinic/Group Practice 2163880568 Receives reassigned benefits from 1 practitioner
Practice locations: Jarrettsville, MD; Nottingham, MD
O20260224000641 MD DME Supplier - Physician - OptometristDME Supplier - Other 2163880568 Practice locations: Nottingham, MD

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
21D2286606McConkey Eye Care LLC4425 Fitch Ave #120, Nottingham, MD 21236Certificate of waiverJul 31, 2027
21D2314161McConkey Eye Care LLC1128 Baldwin Mill Rd, Jarrettsville, MD 21084Certificate of waiverNov 13, 2026

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
McConkey Eye Care LLC4425 Fitch Ave, Nottingham, MD 21236-3927(443) 453-5444 Ocular Prostheses Does not accept assignmentParticipating since Jun 1, 2023

National Provider Directory

National Provider Directory

Locations

1128 Baldwin Mill Rd
Jarrettsville, MD 21084
Phone (410) 692-5591

4425 Fitch Ave
Ste 120
Nottingham, MD 21236
Phone (410) 459-5320

Practitioners & affiliated clinicians

Practitioners 1

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": "1683676800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1716422400000",
    "number": "1902596224",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1420 SARATOGA DR",
            "city": "BEL AIR",
            "state": "MD",
            "postal_code": "210145516",
            "telephone_number": "410-459-5320"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4425 FITCH AVE STE 120",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212363927",
            "telephone_number": "410-459-5320"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1128 Baldwin Mill Rd",
            "address_purpose": "LOCATION",
            "city": "Jarrettsville",
            "state": "MD",
            "postal_code": "210841914",
            "country_code": "US",
            "telephone_number": "443-453-5444",
            "fax_number": "443-453-5114",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MCCONKEY EYE CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-05-10",
        "last_updated": "2024-05-23",
        "certification_date": "2024-05-23",
        "status": "A",
        "authorized_official_last_name": "MCCONKEY",
        "authorized_official_first_name": "WHITNEY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "410-459-5320",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2024; 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.