Carroll W Poovey Jr Optometrist

Primary specialty

OptometristTaxonomy code 152W00000X

License

0618000105 Issued in VA

Legal business name

CARROLL W POOVEY JR OPTOMETRIST

Practice address

2400 N Franklin St
Christiansburg, VA 24073-1088

Phone

(540) 381-3366

Fax

(540) 381-2007

NPI assigned

Jul 12, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Carroll Wilburn Poovey Jr., O.D.

Title

President

Phone

(540) 381-3366

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

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

{
    "created_epoch": "1184198400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1397692800000",
    "number": "1982803615",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 648",
            "city": "CHRISTIANSBURG",
            "state": "VA",
            "postal_code": "240680648",
            "telephone_number": "540-381-3366",
            "fax_number": "540-381-2007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2400 N FRANKLIN ST",
            "city": "CHRISTIANSBURG",
            "state": "VA",
            "postal_code": "240731088",
            "telephone_number": "540-381-3366",
            "fax_number": "540-381-2007"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CARROLL W POOVEY JR OPTOMETRIST",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-12",
        "last_updated": "2014-04-17",
        "status": "A",
        "authorized_official_last_name": "POOVEY",
        "authorized_official_first_name": "CARROLL",
        "authorized_official_middle_name": "WILBURN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "540-381-3366",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "VA",
            "license": "0618000105",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "009237399",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL NPI",
            "identifier": "1699785972",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• All providers in Christiansburg, VA
• Optometrist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2014; 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.