Magnolia Place Eyecare LLC

Primary specialty

OptometristTaxonomy code 152W00000X

Legal business name

MAGNOLIA PLACE EYECARE LLC

Practice address

1609 Gilmer Ave
Tallassee, AL 36078-2343

Phone

(334) 283-6535

Fax

(334) 283-5996

NPI assigned

Dec 15, 2021

Organization subpart

No

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

Authorized official

Name

Dr. Paris Mullins Jr., ODNPI 1447367883

Title

Doctor/Owner

Phone

(334) 283-6535

Specialties & licenses 1

Addresses

Other names 1

• Dr. Paris Mullins, Jr. O.D. Former legal business name

Medicare fee-for-service enrollment

Enrolled in AL

Enrollment records 1

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

Medicare medical equipment & supply locations

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Paris Mullins Jr., OD

  • Optometrist
  • Tallassee, AL
  • NPI 1447367883
  Medicare reassignment Care Compare group NPD Authorized official
• Nicholas Harding Mullins, OD

  • Optometrist
  • Tallassee, AL
  • NPI 1508430042
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1639526400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1639526400000",
    "number": "1922767136",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1609 GILMER AVE",
            "city": "TALLASSEE",
            "state": "AL",
            "postal_code": "360782343",
            "telephone_number": "334-283-6535",
            "fax_number": "334-283-5996"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1609 GILMER AVE",
            "city": "TALLASSEE",
            "state": "AL",
            "postal_code": "360782343",
            "telephone_number": "334-283-6535",
            "fax_number": "334-283-5996"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAGNOLIA PLACE EYECARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-12-15",
        "last_updated": "2021-12-15",
        "certification_date": "2021-12-15",
        "status": "A",
        "authorized_official_last_name": "MULLINS",
        "authorized_official_first_name": "PARIS",
        "authorized_official_title_or_position": "DOCTOR/OWNER",
        "authorized_official_telephone_number": "334-283-6535",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "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": [
        {
            "organization_name": "Dr. Paris Mullins, Jr. O.D.",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Diana L Kenyon, CRNP
• Mary Kate Lackey
• Donna Lindsey
• Morgan Brantley Lock, PHARMD
• Suzanne M Lynch
• Charles D McCartha, DMD
• Mended Spaces Educational Services LLC
• Marcial J Mendez
• Michael a Courtney, M.D.
• Michael W. Peaden MD PC

• Optometrist in Tallassee, AL
• Providers in Tallassee, AL by specialty
• Optometrist in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2021; 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.