Ennen Eye Center, P.a.

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

Legal business name

ENNEN EYE CENTER, P.A.

Doing business as

Ennen Eye Center

Practice address

3312 S 70TH St
Fort Smith, AR 72903-5052

Phone

(479) 452-7800

Fax

(479) 452-9486

NPI assigned

Mar 29, 2006

Organization subpart

No

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

Authorized official

Name

Randy M. Ennen, M.D.

Title

President

Phone

(479) 452-7800

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• Ennen Eye Center Doing business as

Medicare fee-for-service enrollment

Enrolled in AR2 enrollments

Enrollment records 2

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Medicare medical equipment & supply locations

Locations

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Parker Pratt, OD

  • Optometrist
  • Fort Smith, AR
  • NPI 1154807162
  Medicare reassignment Care Compare group NPD
• Christopher Joel Rodriguez, MD

  • Ophthalmology Physician
  • Fort Smith, AR
  • NPI 1942573639

  Single Specialty

  Medicare reassignment Care Compare group NPD
• Adam Michael Schluterman, O.D.

  • Optometrist
  • Fort Smith, AR
  • NPI 1316102437
  Medicare reassignment Care Compare group NPD
• Joseph Leslie Zimmer, MD

  • Ophthalmology Physician
  • Temple, TX
  • NPI 1063048098

  AR

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1143590400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1334188800000",
    "number": "1003877150",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3312 S 70TH ST",
            "city": "FORT SMITH",
            "state": "AR",
            "postal_code": "729035052",
            "telephone_number": "479-452-7800",
            "fax_number": "479-452-9486"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3312 S 70TH ST",
            "city": "FORT SMITH",
            "state": "AR",
            "postal_code": "729035052",
            "telephone_number": "479-452-7800",
            "fax_number": "479-452-9486"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ENNEN EYE CENTER, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-29",
        "last_updated": "2012-04-12",
        "status": "A",
        "authorized_official_last_name": "ENNEN",
        "authorized_official_first_name": "RANDY",
        "authorized_official_middle_name": "M.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "479-452-7800",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100177380B",
            "state": "OK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "152215002",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ennen Eye Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Encompass Health Rehabilitation Hospital of Fort Smith, LLC
• Krista Rose England, LAC
• Lydia England, CNA
• Aaron Michael English, PA-C
• Sierra English, QBHP
• Randy M Ennen, M.D.
• Elizabeth Renee Eoff, M.S., CCC-SLP
• Nicole Ervin, MHPP
• Heather Erwin, WHNP-BC
• Mayra Esquivel, MHPP

• Ophthalmology Physician in Fort Smith, AR
• Providers in Fort Smith, AR by specialty
• Ophthalmology Physician in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.