NPIMap

Organization Active NPI

Muscle Shoals Eye Center

  • Optometrist
  • Muscle Shoals, AL
National Provider Identifier
1932462264
Registry record updated Jun 21, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
S722TA009 Issued in AL
Legal business name
MUSCLE SHOALS EYE CENTER
Practice address
1112 Avalon Ave
Muscle Shoals, AL 35661-2404
Phone
(256) 766-3139
Fax
(256) 767-7374
NPI assigned
Jun 21, 2012
Organization subpart
Yes
Parent organization
FLORENCE EYE CENTER INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 21, 2012

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

Authorized official

Name
Heather L Davis
Title
Office MGR
Phone
(256) 766-3139

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X S722TA009 AL Primary

Addresses

Primary practice location

1112 Avalon Ave
Muscle Shoals, AL 35661-2404

Mailing address

711 Cox Creek Pkwy
Florence, AL 35630-1001
Phone (256) 766-3139

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20051101000058 AL Part B Supplier - Clinic/Group Practice 4082631874 Receives reassigned benefits from 6 practitioners
4 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Muscle Shoals, AL; Florence, AL; Madison, AL

Other NPIs on the same Medicare enrollment 4

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Florence Eye Center Inc3 organizations share this tax ID, including this one
Part of
Florence Eye Center Inc

Other organizations with this tax ID 2

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

Locations

1112 Avalon Ave
Muscle Shoals, AL 35661
Phone (256) 246-2965

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

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

{
    "created_epoch": "1340236800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1340236800000",
    "number": "1932462264",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "711 COX CREEK PKWY",
            "city": "FLORENCE",
            "state": "AL",
            "postal_code": "356301001",
            "telephone_number": "256-766-3139",
            "fax_number": "256-767-7374"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1112 AVALON AVE",
            "city": "MUSCLE SHOALS",
            "state": "AL",
            "postal_code": "356612404",
            "telephone_number": "256-766-3139",
            "fax_number": "256-767-7374"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MUSCLE SHOALS EYE CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "FLORENCE EYE CENTER INC",
        "enumeration_date": "2012-06-21",
        "last_updated": "2012-06-21",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "HEATHER",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OFFICE MGR",
        "authorized_official_telephone_number": "256-766-3139"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "AL",
            "license": "S722TA009",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Muscle Shoals, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2012; 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.