Corey Ray Mairs, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

638 Issued in ND

Practice address

17 11TH Avenue West
Lisbon, ND 58054-0916

Phone

(701) 683-5815

Fax

(701) 683-9966

NPI assigned

Jan 24, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in ND

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Optometry

Education

Pacific University - College of Optometry, 2001

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Lisbon Vision Center, P.C.

  • Optometrist
  • Lisbon, ND
  • NPI 1407896673
  Medicare reassignment NPD Authorized official
• Enhanced Eye Care LLC

  • Optometrist
  • New Richmond, WI
  • NPI 1356171862
  NPD (past)
• Jeffrey W. Williams, O.D. & Associates, PA

  • Eyewear Supplier
  • New Richmond, WI
  • NPI 1265502272
  NPD (past)

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

{
    "created_epoch": "1138060800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1205366400000",
    "number": "1992775944",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 916",
            "city": "LISBON",
            "state": "ND",
            "postal_code": "580540916",
            "telephone_number": "701-683-5815",
            "fax_number": "701-683-9966"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17 11TH AVENUE WEST",
            "city": "LISBON",
            "state": "ND",
            "postal_code": "580540916",
            "telephone_number": "701-683-5815",
            "fax_number": "701-683-9966"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAIRS",
        "first_name": "COREY",
        "middle_name": "RAY",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-24",
        "last_updated": "2008-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "ND",
            "license": "638",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "60623",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lisbon Vision Center, P.C.
• Kristina M Long, LPC
• Susan Marie Long, PHARM.D.
• Rudolf Loperena, MD
• Brenda M Maddox
• Rudie Esther Mala
• Jill Marie McRitchie, PHARM.D., R.PH.
• Mobilityplus Rehabilitation, LTD
• Marie Nelson
• Ryan M Nelson, DDS

• Optometrist in Lisbon, ND
• Providers in Lisbon, ND by specialty
• Optometrist in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.