Active NPI
Lamont Tyler Bunyon, O.D.
- Corneal and Contact Management Optometrist
- Temple Hills, MD
National Provider Identifier
1922141076
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Corneal and Contact Management Optometrist
- License
- TA1617
- Practice address
- 3731 Branch Ave
Suite #211
Temple Hills, MD 20748-1404 - Phone
- (301) 702-0090
- Fax
- (301) 702-0023
- NPI assigned
- Feb 15, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Corneal and Contact Management Optometrist | 152WC0802X | TA1617 | MD | Primary |
Addresses
Primary practice location
3731 Branch Ave
Suite #211
Temple Hills, MD 20748-1404
Mailing address
3731 Branch Ave
Suite #211
Temple Hills, MD 20748-1404
Phone (301) 702-0090
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| TA1617 | Other | MD | STATE LICENSE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| TA1617 | MD | MD | Corneal and Contact Management Optometrist |
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": "1183852800000",
"number": "1922141076",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3731 BRANCH AVE",
"address_2": "SUITE #211",
"city": "TEMPLE HILLS",
"state": "MD",
"postal_code": "207481404",
"telephone_number": "301-702-0090",
"fax_number": "301-702-0023"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3731 BRANCH AVE",
"address_2": "SUITE #211",
"city": "TEMPLE HILLS",
"state": "MD",
"postal_code": "207481404",
"telephone_number": "301-702-0090",
"fax_number": "301-702-0023"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BUNYON",
"first_name": "LAMONT",
"middle_name": "TYLER",
"name_prefix": "Dr.",
"credential": "O.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-02-15",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "152WC0802X",
"taxonomy_group": "",
"desc": "Optometrist, Corneal and Contact Management",
"state": "MD",
"license": "TA1617",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE LICENSE",
"identifier": "TA1617",
"state": "MD"
}
],
"endpoints": [],
"other_names": []
}Other providers in Temple Hills, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.