Rolling Fork Eye Clinic

Primary specialty

OptometristTaxonomy code 152W00000X

Legal business name

ROLLING FORK EYE CLINIC

Practice address

64 S Fourth St
Rolling Fork, MS 39159-5147

Phone

(662) 873-4045

Fax

(662) 873-4452

NPI assigned

Apr 10, 2007

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ms. Ruth C Anderson

Title

Practice Manager

Phone

(662) 332-0163

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

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.

• Wilburn Lord Jr., O.D.

  • Optometrist
  • Greenville, MS
  • NPI 1548301864
  NPD (past)

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

{
    "created_epoch": "1176163200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1013130988",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 185",
            "city": "ROLLING FORK",
            "state": "MS",
            "postal_code": "391590185",
            "telephone_number": "662-873-4045",
            "fax_number": "662-873-4452"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "64 S FOURTH ST",
            "city": "ROLLING FORK",
            "state": "MS",
            "postal_code": "391595147",
            "telephone_number": "662-873-4045",
            "fax_number": "662-873-4452"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROLLING FORK EYE CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-10",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ANDERSON",
        "authorized_official_first_name": "RUTH",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "662-332-0163",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00087850",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Allen Brantley Pearson, FNP-C
• Casey Cummins Perry, PHARM. D.
• RCG of Mayersville, LLC
• Rolling Fork Drug Co (Rolling Fork Drug Company LTC)
• Rolling Fork Drug Co
• Rolling Fork Medical Clinic, LLC
• Sharkey Issaquena Comm Hosp - Ekg
• Sharkey Issaquena Comm Hosp-Ambulance
• Sharkey Issaquena Comm Hosp-ER
• Sharkey Issaquena Comm Hospital - Radiology

• Optometrist in Rolling Fork, MS
• Providers in Rolling Fork, MS by specialty
• Optometrist in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.