Individual provider Active NPI

Mia S Boyland I, O.D.

  • Optometrist
  • Memphis, TN
National Provider Identifier
1972620011
Registry record updated Jun 2, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1871 Issued in TN
Practice address
2389 Lamar Ave
Suite 101
Memphis, TN 38114-3709
Phone
(901) 744-0888
Fax
(901) 744-0888
NPI assigned
Mar 23, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 2, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 1871 TN Primary
Optometrist 152W00000X 670 MS

Addresses

Primary practice location

2389 Lamar Ave
Suite 101
Memphis, TN 38114-3709

Mailing address

PO Box 723
Memphis, TN 38101-0723
Phone (901) 744-0888

Other names 1

  • Dr. Mia S Boyland Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
1871TNMDAthletic Trainer
670MSMDMassage Therapist

NPI Registry JSON

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

{
    "created_epoch": "1174608000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1464825600000",
    "number": "1972620011",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 723",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381010723",
            "telephone_number": "901-744-0888",
            "fax_number": "901-744-0888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2389 LAMAR AVE",
            "address_2": "SUITE 101",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381143709",
            "telephone_number": "901-744-0888",
            "fax_number": "901-744-0888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOYLAND",
        "first_name": "MIA",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "name_suffix": "I",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-23",
        "last_updated": "2016-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TN",
            "license": "1871",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MS",
            "license": "670",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MIA",
            "last_name": "BOYLAND",
            "middle_name": "S",
            "prefix": "DR.",
            "credential": "O.D.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Memphis, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2016; 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.