Midtowne Vision Center, Inc

Primary specialty

OptometristTaxonomy code 152W00000X

License

1471 Issued in GA

Legal business name

MIDTOWNE VISION CENTER, INC

Practice address

635 Pio Nono Ave
Macon, GA 31204-3531

Phone

(478) 803-0001

Fax

(478) 254-4997

NPI assigned

Oct 26, 2009

Organization subpart

No

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

Authorized official

Name

Dr. Miriam D Turner, OD

Title

Office Administrator

Phone

(478) 803-0001

Specialties & licenses 5

Addresses

Other identifiers 2

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

{
    "created_epoch": "1256515200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1317340800000",
    "number": "1992031074",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "635 PIO NONO AVE",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312043531",
            "telephone_number": "478-803-0001",
            "fax_number": "478-254-4997"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "635 PIO NONO AVE",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312043531",
            "telephone_number": "478-803-0001",
            "fax_number": "478-254-4997"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIDTOWNE VISION CENTER, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-10-26",
        "last_updated": "2011-09-30",
        "status": "A",
        "authorized_official_last_name": "TURNER",
        "authorized_official_first_name": "MIRIAM",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "OFFICE ADMINISTRATOR",
        "authorized_official_telephone_number": "478-803-0001",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": "GA",
            "license": "1471",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": "GA",
            "license": "002520",
            "primary": false
        },
        {
            "code": "152WP0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist, Pediatrics",
            "state": "GA",
            "license": "1471",
            "primary": false
        },
        {
            "code": "152WP0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist, Pediatrics",
            "state": "GA",
            "license": "002520",
            "primary": false
        },
        {
            "code": "152WV0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist, Vision Therapy",
            "state": "GA",
            "license": "002520",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000687981G",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UPIN",
            "identifier": "U746489",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Optometrist in Macon, GA
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• Optometrist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2011; 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.