Reservoir Eye Care Clinic PLLC

Primary specialty

OptometristTaxonomy code 152W00000X

License

641 Issued in MS

Legal business name

RESERVOIR EYE CARE CLINIC PLLC

Practice address

536 Lindley Rd
Meridian, MS 39305-2301

Phone

(601) 613-8403

NPI assigned

Sep 18, 2014

Last updated

Sep 18, 2014By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Cassandra Clements-Matney

Title

OD/Owner

Phone

(601) 613-8403

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1410998400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1410998400000",
    "number": "1952703209",
    "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": "601-613-8403"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "536 LINDLEY RD",
            "city": "MERIDIAN",
            "state": "MS",
            "postal_code": "393052301",
            "telephone_number": "601-613-8403"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RESERVOIR EYE CARE CLINIC PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-09-18",
        "last_updated": "2014-09-18",
        "status": "A",
        "authorized_official_last_name": "CLEMENTS-MATNEY",
        "authorized_official_first_name": "CASSANDRA",
        "authorized_official_title_or_position": "OD/OWNER",
        "authorized_official_telephone_number": "601-613-8403"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MS",
            "license": "641",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Region Ten State of Ms (Weems Community Mental Health Center IDD Services)
• Regional Medical Support Center, Inc
• Kenneth J. Reid Jr., M.D.
• Sasha L Reid
• William F Reid, M.D.
• Reuben R. Little, DDS, P. C.
• Kelly M Reynerson, LMSW
• Jessica Reynolds, FNP-C
• Joel Charles Reynolds, M.D.
• Stacey Rhodes, MD

• Optometrist in Meridian, MS
• Providers in Meridian, MS by specialty
• Optometrist in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2014; 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.