NPIMap

Organization Active NPI

Verve Ophthalmic Group LLC

  • Optometrist
  • Mesa, AZ
National Provider Identifier
1962711234
Registry record updated Oct 4, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1584 Issued in AZ
Legal business name
VERVE OPHTHALMIC GROUP LLC
Practice address
4824 E Baseline Rd Ste 140
Mesa, AZ 85206-4680
Phone
(480) 969-4040
Fax
(480) 830-9202
NPI assigned
Oct 4, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 4, 2010

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

Authorized official

Name
Dr. Taylor McMullen, O.D.
Title
Doctor
Phone
(480) 969-4040

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193200000X MULTI-SPECIALTY GROUP 152W00000X 1584 AZ Primary

Addresses

Primary practice location

4824 E Baseline Rd Ste 140
Mesa, AZ 85206-4680

Mailing address

4824 E Baseline Road
Suite 140
Mesa, AZ 85206
Phone (480) 969-4040

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1286150400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1286150400000",
    "number": "1962711234",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4824 E BASELINE ROAD",
            "address_2": "SUITE 140",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "85206",
            "telephone_number": "480-969-4040",
            "fax_number": "480-830-9202"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4824 E BASELINE RD STE 140",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852064680",
            "telephone_number": "480-969-4040",
            "fax_number": "480-830-9202"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VERVE OPHTHALMIC GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-10-04",
        "last_updated": "2010-10-04",
        "status": "A",
        "authorized_official_last_name": "MCMULLEN",
        "authorized_official_first_name": "TAYLOR",
        "authorized_official_title_or_position": "DOCTOR",
        "authorized_official_telephone_number": "480-969-4040",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": "AZ",
            "license": "1584",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesa, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2010; 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.