MR. EDWARD MITCHELL JR. LDO NPI 1811139462

Eyewear Supplier in Crestview, FL

NPI 1811139462 Individual Male Eyewear Supplier

About EDWARD MITCHELL

Edward Mitchell is a provider established in Crestview, Florida and his medical specialization is eyewear supplier. The NPI number of Edward Mitchell is 1811139462 and was assigned on March 2009. The practitioner's primary taxonomy code is 332H00000X with license number DO5539 (FL). The provider is registered as an individual and his NPI record was last updated 2 years ago.

Edward Mitchell is a non-participating provider of Medicare. If you are a Medicare beneficiary this means the provider can charge up to 15% more than Medicare's approved amount for the cost of rendered services, in addition to your normal deductible and coinsurance costs. There are some states that restrict the limiting charge when you see non-participating provider. If you pay the full cost of your care up front, your non- participating provider should still submit a claim to Medicare. Afterward, you should receive reimbursement from Medicare for up 80% of the Medicare-approved amount for the services rendered.

NPI

1811139462

Provider NameMR. EDWARD MITCHELL JR. LDO
Provider Location Address4100 S FERDON BLVD STE B5 CRESTVIEW, FL 32536
Provider Mailing Address4100 S FERDON BLVD STE B5 CRESTVIEW, FL 32536
GenderMale
NPI Entity TypeIndividual
Is Sole Proprietor?Yes
Is Organization Subpart?N/A
Enumeration Date03-28-2009
Last Update Date10-15-2019


Primary Taxonomy

Taxonomy Code332H00000X
ClassificationEyewear Supplier
TypeSuppliers
License No.DO5539
License StateFL
Taxonomy DescriptionAn organization that provides spectacles, contact lenses, and other vision enhancement devices prescribed by an optometrist or ophthalmologist.

Business Address

MR. EDWARD MITCHELL JR. LDO
4100 S FERDON BLVD STE B5
CRESTVIEW, FL
ZIP 32536
Phone: (850) 758-0474
Fax: (850) 682-0057

Get Directions


Mailing Address

MR. EDWARD MITCHELL JR. LDO
4100 S FERDON BLVD STE B5
CRESTVIEW, FL
ZIP 32536
Phone: (850) 758-0474
Fax: (850) 682-0057



Secondary Locations

4724 Whitewater Ln
Crestview, FL 32539
(850) 826-0698

Secondary Taxonomies


The secondary taxonomy codes define the provider type, classification, and specialization. For individual NPIs the license data is associated to each taxonomy code.

No. Taxonomy Code Type Classification Specialization License No. State Primary
1156FC0801XEye and Vision Services ProvidersTechnician/TechnologistContact Lens FitterDO 5539FLNo

Taxonomy Description: an optician or other ancillary support staff person who, where authorized by state law and trained or certified to do so, may fit or dispense contact lenses to a patient based on the prescription of an optometrist or medical physician.

2156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOpticianDO 5539FLNo

Taxonomy Description: Not Available

3156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician5539FLNo

Taxonomy Description: Not Available

Additional Identifiers


Additional identifier(s) currently or formerly used as an identifier for the provider. The codes may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State
80-0442282OTHER (01)

NPI Footnotes

What is the National Provider Indentifier (NPI)?
The NPI is 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.

Provider Location Address
The location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.

Provider Mailing Address
The mailing address of the provider being identified. This address may contain the same information as the provider location address.

Entity Type Code
The code describing the type of health care provider that is being assigned an NPI.
The entity type codes are:
1 = Person: individual human being who furnishes health care;
2 = Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)

What is a Subpart?
Subparts are the components and separate physical locations of organization health care providers. Subpart examples include:
Hospital components include outpatient departments, surgical centers, psychiatric units, and laboratories. These components are often separately licensed or certified by States and may exist at physical locations other than that of the hospital of which they are a component.

Provider Other Organization Name
The other organization name is the alternative last name by which the provider is or has been known (if an individual) or other name by which the organization provider is or has been known. The code identifying the type of other name. The provider other organization name codes are:
1 = former name;
2 = professional name;
3 = doing business as (d/b/ a) name;
4 = former legal business name; :
5 = other.

Provider Enumeration Date
The date the provider was assigned a unique identifier (assigned an NPI).

Last Update Date
The date that a NPI record was last updated or changed.

Primary Taxonomy Code
The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Authorized Official Name
The name of the person authorized to submit the NPI application or to officially change data for a health care provider.