Active NPI
Family Eye Care Center, Inc.
- Optometrist
- Camden, AR
National Provider Identifier
1003145319
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 2570
- Legal business name
- FAMILY EYE CARE CENTER, INC.
- Practice address
- 515 Cash Rd SW
Camden, AR 71701-3706 - Phone
- (870) 836-2525
- Fax
- (870) 836-7252
- NPI assigned
- Dec 15, 2009
- Last updated
- Jan 8, 2014
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Jerry Nutt, O.D.
- Title
- President
- Phone
- (870) 836-2525
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 2570 | AR | Primary |
| Optometrist | 152W00000X | 2582 | AR |
Addresses
Primary practice location
515 Cash Rd SW
Camden, AR 71701-3706
Mailing address
515 Cash Rd SW
Camden, AR 71701-3706
Phone (870) 836-2525
Other identifiers 7
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 57839 | Other | AR | ARK BCBS-MEDIPAK |
| 181078722 | Medicaid | AR | |
| 57839 | Other | BLUE ADVANTAGE | |
| 57839 | Other | AR | ARKANSAS BLUE CROSS & BLUE SHIELD |
| 57839 | Other | AR | HEALTH ADVANTAGE |
| 57839 | Other | AR | MEDIPAK ADVANTAGE |
| 57839 | Other | AR | BLUE CARD/ AR BCBS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in AR
Enrollment records 2
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20100222000197 | AR | Part B Supplier - Clinic/Group Practice | 3678617115 |
Receives reassigned benefits from 2 practitioners 1 other NPI on this enrollment Practice locations: Camden, AR; Fordyce, AR |
| O20100930009276 | AR | DME Supplier - Physician - Optometrist | 3678617115 | Practice locations: Camden, AR |
Other NPIs on the same Medicare enrollment 1
NPIs listed together on one Medicare enrollment, typically parts of the same organization.
National Provider Directory
National Provider Directory- Tax ID family
- Family Eyecare Center Inc
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Optometrist
- Fordyce, AR
- NPI 1962836585
Locations
515 Cash Rd SW
Camden, AR 71701
Phone (870) 836-2525
Practitioners & affiliated clinicians
Practitioners 2
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
-
- Optometrist
- Camden, AR
- NPI 1871685065
-
- Optometrist
- Camden, AR
- NPI 1265446793
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1260835200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1389139200000",
"number": "1003145319",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "515 CASH RD SW",
"city": "CAMDEN",
"state": "AR",
"postal_code": "717013706",
"telephone_number": "870-836-2525",
"fax_number": "870-836-7252"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "515 CASH RD SW",
"city": "CAMDEN",
"state": "AR",
"postal_code": "717013706",
"telephone_number": "870-836-2525",
"fax_number": "870-836-7252"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "FAMILY EYE CARE CENTER, INC.",
"organizational_subpart": "NO",
"enumeration_date": "2009-12-15",
"last_updated": "2014-01-08",
"status": "A",
"authorized_official_last_name": "NUTT",
"authorized_official_first_name": "JERRY",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "870-836-2525",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "O.D."
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Optometrist",
"state": "AR",
"license": "2570",
"primary": true
},
{
"code": "152W00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Optometrist",
"state": "AR",
"license": "2582",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ARK BCBS-MEDIPAK",
"identifier": "57839",
"state": "AR"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "181078722",
"state": "AR"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE ADVANTAGE",
"identifier": "57839",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ARKANSAS BLUE CROSS & BLUE SHIELD",
"identifier": "57839",
"state": "AR"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTH ADVANTAGE",
"identifier": "57839",
"state": "AR"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDIPAK ADVANTAGE",
"identifier": "57839",
"state": "AR"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CARD/ AR BCBS",
"identifier": "57839",
"state": "AR"
}
],
"endpoints": [],
"other_names": []
}Other providers in Camden, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.