Professional Opticians, LLC

Primary specialty

Eyewear SupplierTaxonomy code 332H00000X

License

1048 Issued in NC

Legal business name

PROFESSIONAL OPTICIANS, LLC

Practice address

5000 S Croatan Hwy
Nags Head, NC 27959-8500

Phone

(252) 441-6353

NPI assigned

Apr 5, 2010

Organization subpart

No

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

Authorized official

Name

Mary C Maxwell

Title

Owner/Optician

Phone

(252) 441-6353

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1270425600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1270425600000",
    "number": "1972828838",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1088",
            "city": "NAGS HEAD",
            "state": "NC",
            "postal_code": "279591088",
            "telephone_number": "252-441-6353"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5000 S CROATAN HWY",
            "city": "NAGS HEAD",
            "state": "NC",
            "postal_code": "279598500",
            "telephone_number": "252-441-6353"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROFESSIONAL OPTICIANS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-04-05",
        "last_updated": "2010-04-05",
        "status": "A",
        "authorized_official_last_name": "MAXWELL",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "OWNER/OPTICIAN",
        "authorized_official_telephone_number": "252-441-6353"
    },
    "taxonomies": [
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": "NC",
            "license": "1048",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8802047",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Eyewear Supplier in Nags Head, NC
• Providers in Nags Head, NC by specialty
• Eyewear Supplier in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 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.