Mythic Eyewear LLC

Primary specialty

OpticianTaxonomy code 156FX1800X

Legal business name

MYTHIC EYEWEAR LLC

Practice address

1025 Ahwenasa TRL
Macon, GA 31220-3606

Phone

(478) 973-2227

NPI assigned

Mar 6, 2024

Last updated

Mar 6, 2024By 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

Travis Sconyers, LDO

Title

Owner

Phone

(478) 973-2227

Specialties & licenses 9

Addresses

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

{
    "created_epoch": "1709683200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1709683200000",
    "number": "1982462875",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4658 PRESIDENTIAL PKWY # 1058",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312068708",
            "telephone_number": "478-973-2227"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1025 AHWENASA TRL",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312203606",
            "telephone_number": "478-973-2227"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MYTHIC EYEWEAR LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-03-06",
        "last_updated": "2024-03-06",
        "certification_date": "2024-03-06",
        "status": "A",
        "authorized_official_last_name": "SCONYERS",
        "authorized_official_first_name": "TRAVIS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "478-973-2227",
        "authorized_official_credential": "LDO"
    },
    "taxonomies": [
        {
            "code": "156F00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Technician/Technologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "156FC0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Technician/Technologist, Contact Lens",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "156FC0801X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Technician/Technologist, Contact Lens Fitter",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "156FX1100X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Technician/Technologist, Ophthalmic",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "156FX1101X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Technician/Technologist, Ophthalmic Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "156FX1201X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Technician/Technologist, Optometric Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "156FX1202X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Technician/Technologist, Optometric Technician",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "156FX1800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Technician/Technologist, Optician",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joneshia Myles, LMT
• Valencia Natavious Myrick
• Flesha Myricks, LPN
• Gary Jonathan Myrthil, MD
• Elijah Myrtil
• N. Tyrus Ivey, DDS, PC
• Nehal Nadeem, M.D.
• Zahra Naderi, MD
• Shanzae Naeem, M.D.
• Sushmita Nair, MD

• Optician in Macon, GA
• Providers in Macon, GA by specialty
• Optician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2024; 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.