CUSTOM OPTICAL OF FONDREN LLC
NPI 1467622605
Eyewear Supplier in Jackson, MS

NPI Status: Active since March 04, 2008

Contact Information

661 DULING AVE
JACKSON, MS
ZIP 39216
Phone: (601) 362-6675
Fax: (601) 362-5767

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  • Organization
  • Eyewear Supplier
  • Medicare Supplier
  • Does Not Accept Medicare Approved Payment

About CUSTOM OPTICAL OF FONDREN LLC

This page provides the complete NPI Profile along with additional information for Custom Optical Of Fondren Llc, a provider established in Jackson, Mississippi operating as a Eyewear Supplier. The healthcare provider is registered in the NPI registry with number 1467622605 assigned on March 2008. The practitioner's primary taxonomy code is 332H00000X. The provider is registered as an organization and their NPI record was last updated 4 years ago. The provider's other name is Custom Optical Of Fondren Llc. The authorized official of this NPI record is Patricia Hammons (Owner/optician)

NPI
1467622605
Provider Legal Name
CUSTOM OPTICAL OF FONDREN LLC
Other Organization Name
CUSTOM OPTICAL OF FONDREN LLC
Other Name Type
Other Name (5)
Entity Type
Organization
Location Address
661 DULING AVE JACKSON, MS 39216
Location Phone
(601) 362-6675
Location Fax
(601) 362-5767
Mailing Address
661 DULING AVE JACKSON, MS 39216
Mailing Phone
(601) 362-6675
Mailing Fax
(601) 362-5767
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
03-04-2008
Last Update Date
04-29-2022
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Custom Optical Of Fondren Llc is a medicare supplier with PTAN 20350535 who does not accept Medicare assignment for all durable medical equipment and supplies. The provider may not accept the Medicare allowable as payment in full and may collect additional payment directly from the patient, and/or charge more than the Medicare allowable.The supplier carries the following product categories: Prosthetic Lenses: Conventional Eyeglasses.

Location Map

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Eyewear Supplier

Taxonomy Code
332H00000X
Type
Suppliers
Taxonomy Description
An organization that provides spectacles, contact lenses, and other vision enhancement devices prescribed by an optometrist or ophthalmologist.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

PATRICIA HAMMONS

Authorized Official Title
OWNER/OPTICIAN
Authorized Official Phone
(601) 362-6675

Medical Equipment Supplier

The provider carries the following medical supplies product categories:

PTAN
20350535
Accepts Medicare Assignment
NO
Specialities List
Optician.
Competitive Bidding
NO

Supplies List

  • Prosthetic Lenses: Conventional Eyeglasses - Conventional Eyeglasses

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NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1467622605, we treat the final digit (5) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 55. The final step is to find the difference between that total and the next multiple of ten (60 - 55 = 5).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
4
Unchanged
Pos 3
6
Doubled → 12 → 1 + 2
Pos 4
7
Unchanged
Pos 5
6
Doubled → 12 → 1 + 2
Pos 6
2
Unchanged
Pos 7
2
Doubled → 4
Pos 8
6
Unchanged
Pos 9
0
Doubled → 0
Check
5
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 6 → 12 → 3 6 → 12 → 3 2 → 4 0 → 0

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 4 + 1 + 2 + 7 + 1 + 2 + 2 + 4 + 6 + 0 + 24 = 55

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 55 is 60. The difference is the calculated check digit.

60 - 55 = 5
This NPI is valid
The calculated check digit is 5, which matches the last digit of 1467622605.

Other Providers at the Same Location


The following 1 provider is registered at the same or a nearby location.

Technician/Technologist (Optician)
661 DULING AVE
JACKSON, MS 39216

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1467622605, enumerated as an "organization" on March 04, 2008.

The provider is located at 661 DULING AVE JACKSON, MS 39216 and the phone number is (601) 362-6675.

Eyewear Supplier with taxonomy code 332H00000X.