NPIMap

Individual provider Active NPI

Cassandra Leigh Clements Matney, O.D.

  • Optometrist
  • Meridian, MS
National Provider Identifier
1922199751
Registry record updated Oct 2, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
641 Issued in MS
Practice address
910 23Rd Ave
Meridian, MS 39301-5017
Phone
(601) 482-2020
Fax
(601) 693-1847
NPI assigned
Sep 27, 2006
Last updated
Oct 2, 2013By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 2, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 641 MS Primary

Addresses

Primary practice location

910 23Rd Ave
Meridian, MS 39301-5017

Mailing address

PO Box 2887
Meridian, MS 39302-2887
Phone (601) 482-2020

Other identifiers 2

IdentifierTypeStateIssuer
MC2384802OtherUS DEPT OF JUSTICE
00880188MedicaidMS

Other names 1

  • Dr. Cassandra Leigh Clements Former name

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

LicenseStateTypeSpecialty
641MSMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Madison Professional Eyecare Associates, Inc Optometrist Past Accepting new patients
Optical 2000 Optometrist PastSince Jul 12, 2005 Accepting new patients
Optical 2000 of Flora PA Optometrist Past Accepting new patients
Health Care for Life Ms, LLC Optometrist PastSince Jul 28, 2012 Accepting new patients

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": "1159315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1380672000000",
    "number": "1922199751",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2887",
            "city": "MERIDIAN",
            "state": "MS",
            "postal_code": "393022887",
            "telephone_number": "601-482-2020",
            "fax_number": "601-693-1847"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "910 23RD AVE",
            "city": "MERIDIAN",
            "state": "MS",
            "postal_code": "393015017",
            "telephone_number": "601-482-2020",
            "fax_number": "601-693-1847"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLEMENTS MATNEY",
        "first_name": "CASSANDRA",
        "middle_name": "LEIGH",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-27",
        "last_updated": "2013-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MS",
            "license": "641",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "US DEPT OF JUSTICE",
            "identifier": "MC2384802",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00880188",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CASSANDRA",
            "last_name": "CLEMENTS",
            "middle_name": "LEIGH",
            "prefix": "DR.",
            "credential": "O.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Meridian, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.