Carl Byron McInnish, O.D,P.A.

Primary specialty

Vision Therapy OptometristTaxonomy code 152WV0400X

License

S-312-TA-059 Issued in AL

Practice address

106 W Jackson St
Brewton, AL 36426-1516

Phone

(251) 867-3635

Fax

(251) 867-9523

NPI assigned

May 10, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in AL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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.

• C B McInnish, OD PA

  • Optometrist
  • Brewton, AL
  • NPI 1548391337
  Authorized official Same address or phone

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

{
    "created_epoch": "1147219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1318377600000",
    "number": "1922057306",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1268",
            "city": "BREWTON",
            "state": "AL",
            "postal_code": "364271268",
            "telephone_number": "251-867-3635",
            "fax_number": "251-867-9523"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "106 W JACKSON ST",
            "city": "BREWTON",
            "state": "AL",
            "postal_code": "364261516",
            "telephone_number": "251-867-3635",
            "fax_number": "251-867-9523"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCINNISH",
        "first_name": "CARL",
        "middle_name": "BYRON",
        "name_prefix": "Dr.",
        "credential": "O.D,P.A.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-10",
        "last_updated": "2011-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152WV0400X",
            "taxonomy_group": "",
            "desc": "Optometrist, Vision Therapy",
            "state": "AL",
            "license": "S-312-TA-059",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD ID",
            "identifier": "000092846",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000059369",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Deanah Maxwell, MD
• Salena L McCreary
• Miriam McDaniel, CRNA
• Cherlisa Stephens McGhee
• Valon Mariah McGhee
• Dana McLeod, M.S.
• Johanna Charity McPherson
• Michael a. Dasinger
• Stacy Miles, PHARM D
• Alex Miller

• Vision Therapy Optometrist in Brewton, AL
• Providers in Brewton, AL by specialty
• Vision Therapy Optometrist in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.