Individual provider Active NPI

Mandy Lynnette Lanier, OD

  • Optometrist
  • Boone, NC
National Provider Identifier
1902949258
Registry record updated Nov 25, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1982 Issued in NC
Practice address
610 State Farm Rd
Suite a
Boone, NC 28607-4738
Phone
(828) 264-0042
Fax
(828) 264-8612
NPI assigned
Feb 15, 2007
Last updated
Nov 25, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 25, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 1982 NC Primary

Addresses

Primary practice location

610 State Farm Rd
Suite a
Boone, NC 28607-4738

Mailing address

610 State Farm Rd
Suite a
Boone, NC 28607-4738
Phone (828) 264-0042

Other identifiers 4

IdentifierTypeStateIssuer
0853510001OtherNCCIGNA GOVERNMENT SERVICES MEDICARE PART B DME
410034018OtherNCRRMC
093T4OtherNCBCBS
5901497MedicaidNC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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 1

Enrollment IDStateProvider typePAC IDDetails
I20051209000630 NC Practitioner - Optometry 4789649427 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern College of Optometry, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

610 State Farm Rd
Suite a
Boone, NC 28607-4713
Phone 8282640042123

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
100
Improvement activities
40
Cost
100

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1982NCMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Western Carolina Eye Associates, PA Optometrist CurrentSince Apr 18, 2012 Accepting new patients
Western Carolina Eye Associates, PA Optometrist CurrentSince Apr 18, 2012 Accepting new patients
Northeastern State University College of Optometry Optometrist PastSince Jul 1, 2025 Accepting new patients
Academy Eye Center Optometry, PA Optometrist Past Accepting new patients

Locations

610 State Farm Rd
Ste A
Boone, NC 28607
Phone (828) 264-0042

183 Doctors Park Dr
Jefferson, NC 28640

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
  • Direct secure messaging: mandy.lanier@direct.wcea.nextgenshare.com

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1171497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1416873600000",
    "number": "1902949258",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "610 STATE FARM RD",
            "address_2": "SUITE A",
            "city": "BOONE",
            "state": "NC",
            "postal_code": "286074738",
            "telephone_number": "828-264-0042",
            "fax_number": "828-264-8612"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "610 STATE FARM RD",
            "address_2": "SUITE A",
            "city": "BOONE",
            "state": "NC",
            "postal_code": "286074738",
            "telephone_number": "828-264-0042",
            "fax_number": "828-264-8612"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANIER",
        "first_name": "MANDY",
        "middle_name": "LYNNETTE",
        "name_prefix": "Ms.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-15",
        "last_updated": "2014-11-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NC",
            "license": "1982",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA GOVERNMENT SERVICES MEDICARE PART B DME",
            "identifier": "0853510001",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RRMC",
            "identifier": "410034018",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "093T4",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5901497",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Boone, NC

Sources for this page

Verify at the official NPI Registry.