MALLARD EYE CARE, LLC (NPI# 1053962134) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1053962134 |
| Entity Type | Organization |
| Organization Name | MALLARD EYE CARE, LLC |
| Practice Address |
1224 Huntsville Hwy Fayetteville TN 37334-3618 |
| Mailing Address |
4959 Main St Spring Hill TN 37174-2727 |
| Practice Telephone | 9314330906 |
| Practice Fax Number | 6152504911 |
| Mailing Telephone | 6153024477 |
| Mailing Fax Number | 6152504911 |
| Enumeration Date | 2019-09-20 |
| Last Update Date | 2020-01-23 |
| Authorized Official Name | DR. CHRISTOPHER MALLARD (OWNER) |
| Authorized Official Telephone | 6153024477 |
| Authorized Official Credential | OD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 152W00000X | Optometrist | Eye and Vision Services Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TN | PENDING | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912516956 | Mallard Eye Care, LLC | Optometrist | 1334 N Ellington Pkwy # P, Lewisburg, TN 37091-2218 | 2020-07-27 |
| 1487010674 | Mallard Eye Care, LLC | Optometrist | 2200 Brookmeade Dr, Columbia, TN 38401-3994 | 2016-01-05 |
| 1255760286 | Mallard Eye Care, LLC | Optometrist | 4959 Main St, Spring Hill, TN 37174-2727 | 2013-11-12 |
| Street Address |
1224 HUNTSVILLE HWY |
| City | FAYETTEVILLE |
| State | TN |
| Zip Code | 37334-3618 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306863584 | Wal-mart Stores East Lp | Durable Medical Equipment & Medical Supplies | 1224 Huntsville Hwy, Fayetteville, TN 37334-3618 | 2006-07-16 |
| 1972104016 | Avery Cameron Woodall | Pharmacist | 1224 Huntsville Hwy, Fayetteville, TN 37334-3618 | 2020-11-05 |
| 1336636992 | Lorelei B Corder | Pharmacist | 1224 Huntsville Hwy, Fayetteville, TN 37334-3618 | 2018-04-19 |
| 1760979868 | Paige Barnes | Pharmacist | 1224 Huntsville Hwy, Fayetteville, TN 37334-3618 | 2018-04-16 |
| 1487141479 | Christal Taylor | Pharmacist | 1224 Huntsville Hwy, Fayetteville, TN 37334-3618 | 2018-04-16 |
| 1326127705 | Robert Larry Perkins | Optometrist | 1224 Huntsville Hwy, Dr R Larry Perkins, Fayetteville, TN 37334 | 2006-11-04 |
| 1194807016 | Wal-mart Stores East, Lp | Technician/Technologist | 1224 Huntsville Hwy, Fayetteville, TN 37334-3618 | 2006-10-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902385198 | Denisia Bernadette Maldonado | Specialist/Technologist, Other | 108 Medical Center Blvd., Suite #100, Fayetteville, TN 37334 | 2018-08-09 |
| 1457801011 | Joshua Meadows | Specialist/Technologist | 101 Industrial Blvd, Fayetteville, TN 37334 | 2016-10-07 |
| 1891083762 | Kathryn Clare Moran | Physical Therapist | 1412 Huntsville Hwy, Fayetteville, TN 37334 | 2011-07-13 |
| 1891997714 | Calvin H Parks | Chiropractor | 1321 Huntsville Hwy, Fayetteville, TN 37334 | 2007-06-04 |
| 1225249691 | Stacey Starr Pace | Family Medicine | 1931 Wilson Pky, Suite A, Fayetteville, TN 37334 | 2007-05-25 |
| 1144388992 | Tom Spain Bigham IIi | Dentist | 608 West College Street, Fayetteville, TN 37334 | 2006-12-05 |
| 1932286259 | Alan B Drewry | Dentist | 602 West College Street, Fayetteville, TN 37334 | 2006-11-01 |
| 1083724561 | Samuel Michael Ashby | Internal Medicine | 804 William D Jones Blvd, Fayetteville, TN 37334 | 2006-08-30 |
| 1194336818 | Collin Amos | Pharmacist | 1000 Huntsville Hwy, Fayetteville, TN 37334 | 2020-08-14 |
| 1629450614 | William Daniel | Nurse Practitioner | 106 Medical Center Blvd, Fayetteville, TN 37334 | 2015-06-25 |
| Find all providers in zip 37334 | ||||
| Taxonomy Code | 152W00000X |
| Grouping | Eye and Vision Services Providers |
| Classification | Optometrist |
| Doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system. |
| Notes: Source: American Optometric Association (AOA), approved by the AOA’s Board of Trustees, June 21, 2005. [7/1/2006: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679103220 | Atl Optical LLC | Optometrist | 1135 Highway 85 N Ste D, Fayetteville, GA 30214-2085 | 2020-01-23 |
| 1306406269 | Idell Marie Mitchell | Optometrist | Eye Clinic, 1100 N College Ave, Fayetteville, AR 72703 | 2019-06-13 |
| 1922515808 | Focused Family Eye Care, Pllc | Optometrist | 3730 N Vantage Dr, Fayetteville, AR 72703-5442 | 2018-01-02 |
| 1952829186 | Davis Eye Associates Inc. | Optometrist | 2901 E Zion Rd Ste 13, Fayetteville, AR 72703-5070 | 2017-09-08 |
| 1427405133 | National Eye Care, Inc | Optometrist | 5160 Kinloch Circle, Fayetteville, NY 13066 | 2016-05-23 |
| 1356730493 | Myeyedr Optometry of North Carolina, Pllc | Optometrist | 326 Glensford Dr, Suite 108, Fayetteville, NC 28314 | 2015-01-13 |
| 1013314608 | Ashley Ballard | Optometrist | 326 Glensford Dr Ste 108, Fayetteville, NC 28314-3219 | 2014-11-25 |
| 1891108924 | Focus Vision Optometric Care, Pllc | Optometrist | 1594 Skibo Rd, Fayetteville, NC 28303-3478 | 2014-06-06 |
| 1336488204 | Northwest Vision Group | Optometrist | 3215 E Summershade Dr, Fayetteville, AR 72703-4375 | 2013-02-12 |
| 1912257247 | Zachary Robert Engle | Optometrist | 419 Cross Creek Mall, Ste 302, Fayetteville, NC 28303-7285 | 2012-09-13 |
| Find all providers in FAYETTEVILLE | ||||
| City | FAYETTEVILLE |
| Zip Code | 37334 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.