NPIMap

Organization Active NPI

Marion Eye Centers, LTD.

  • Durable Medical Equipment & Medical Supplies
  • Dexter, MO
National Provider Identifier
1932263134
Registry record updated Aug 29, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
Legal business name
MARION EYE CENTERS, LTD.
Doing business as
Marion Eye Centers, Ltd.
Practice address
1207 N One Mile Rd
Dexter, MO 63841-1041
Phone
(573) 624-4584
Fax
(573) 624-4585
NPI assigned
Dec 21, 2006
Last updated
Aug 29, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 29, 2017

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

Authorized official

Name
Maqbool Ahmad, M.D.
Title
President Owner
Phone
(618) 993-5686

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X Primary
Optometrist 152W00000X 35374 MO
Ophthalmology Physician 207W00000X 35374 MO

Addresses

Primary practice location

1207 N One Mile Rd
Dexter, MO 63841-1041

Mailing address

1200 W Deyoung St
P.O. Box 1178
Marion, IL 62959-4437
Phone (618) 993-5686

Other identifiers 2

IdentifierTypeStateIssuer
203169800MedicaidMO
036051996MedicaidIL

Other names 1

  • Marion Eye Centers, Ltd. Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100930039855 MO DME Supplier - Physician - OphthalmologyDME Supplier - Physician - Optometrist 3072426774 Practice locations: Dexter, MO

National Provider Directory

National Provider Directory
Tax ID family
Marion Eye Center29 organizations share this tax ID, including this one

Other organizations with this tax ID 28

Organizations that report the same tax identification number in the National Provider Directory.

View all 28

NPI Registry JSON

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

{
    "created_epoch": "1166659200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1503964800000",
    "number": "1932263134",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 W DEYOUNG ST",
            "address_2": "P.O. BOX 1178",
            "city": "MARION",
            "state": "IL",
            "postal_code": "629594437",
            "telephone_number": "618-993-5686",
            "fax_number": "618-997-5505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1207 N ONE MILE RD",
            "city": "DEXTER",
            "state": "MO",
            "postal_code": "638411041",
            "telephone_number": "573-624-4584",
            "fax_number": "573-624-4585"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARION EYE CENTERS, LTD.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-21",
        "last_updated": "2017-08-29",
        "status": "A",
        "authorized_official_last_name": "AHMAD",
        "authorized_official_first_name": "MAQBOOL",
        "authorized_official_title_or_position": "PRESIDENT OWNER",
        "authorized_official_telephone_number": "618-993-5686",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MO",
            "license": "35374",
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "MO",
            "license": "35374",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "203169800",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036051996",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Marion Eye Centers, Ltd.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Dexter, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.