NPIMap

Organization Active NPI

See Side Optical Inc

  • Optometrist
  • Diamondhead, MS
National Provider Identifier
1962658203
Registry record updated Jan 26, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
574 Issued in MS
Legal business name
SEE SIDE OPTICAL INC
Practice address
5405 Indian Hill Blvd
Diamondhead, MS 39525-3324
Phone
(228) 255-8585
NPI assigned
Aug 18, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 26, 2009

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

Authorized official

Name
Joseph E Gregory, ODNPI 1134210123
Title
President/Doctor
Phone
(228) 255-8585

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 574 MS Primary

Addresses

Primary practice location

5405 Indian Hill Blvd
Diamondhead, MS 39525-3324

Mailing address

5405 Indian Hill Blvd
Diamondhead, MS 39525-3324

Other identifiers 3

IdentifierTypeStateIssuer
1962658203OtherMSNPI
00880009MedicaidMS
1902060643OtherMSNPI

National Provider Directory

National Provider Directory

Locations

5405 Indian Hill Blvd
Diamondhead, MS 39525
Phone (228) 255-8585

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1219017600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1232928000000",
    "number": "1962658203",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5405 INDIAN HILL BLVD",
            "city": "DIAMONDHEAD",
            "state": "MS",
            "postal_code": "395253324"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5405 INDIAN HILL BLVD",
            "city": "DIAMONDHEAD",
            "state": "MS",
            "postal_code": "395253324",
            "telephone_number": "228-255-8585"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SEE SIDE OPTICAL INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-08-18",
        "last_updated": "2009-01-26",
        "status": "A",
        "authorized_official_last_name": "GREGORY",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "PRESIDENT/DOCTOR",
        "authorized_official_telephone_number": "228-255-8585",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "MS",
            "license": "574",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1962658203",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00880009",
            "state": "MS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1902060643",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Diamondhead, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2009; 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.