Individual provider Active NPI

Airiell Schwab, OD

  • Optometrist
  • Cabot, AR
National Provider Identifier
1053417360
Registry record updated Oct 11, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2600 Issued in AR
Practice address
1004 S Pine St
Cabot, AR 72023-3865
Phone
(501) 941-2222
NPI assigned
Sep 15, 2006
Last updated
Oct 11, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 11, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2600 AR Primary

Addresses

Primary practice location

1004 S Pine St
Cabot, AR 72023-3865

Mailing address

1004 South Pine Street
Cabot, AR 72023-4133
Phone (501) 941-2222

Other identifiers 4

IdentifierTypeStateIssuer
0215420001OtherARMEDICARE DMERC REGION C
180288722MedicaidAR
1053417360OtherARMEDICARE DMERC
P00806907OtherARRAIL ROAD MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20091229000122 AR Practitioner - Optometry 2961408836 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern College of Optometry, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Shane E Ford OD PAGroup PAC ID 3678529575, 7 clinicians

Practice addresses (Care Compare)

3005 Fountain Dr
Conway, AR 72034-3684
Phone (501) 329-9851

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery47

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2535COMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Shane E. Ford OD PA Optometrist CurrentSince Jun 4, 2002 Accepting new patients
Jacksonville Vision Development Center PA Optometrist PastSince Nov 3, 2019 Accepting new patients
Shane E. Ford OD PA Optometrist PastSince Feb 2, 2025 Accepting new patients

Locations

2526 Highway 65 S
Ste 104
Clinton, AR 72031
Phone (501) 745-2500

3005 Fountain Dr
Conway, AR 72034
Phone (501) 329-9851

31 Business Park Dr
Ste A
Greenbrier, AR 72058
Phone (501) 679-7131

Interoperability endpoints

  • Direct secure messaging: aschwab1@arkansaseyecaregroup.eyefinity-direct.com

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1158278400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1476144000000",
    "number": "1053417360",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1004 SOUTH PINE STREET",
            "city": "CABOT",
            "state": "AR",
            "postal_code": "720234133",
            "telephone_number": "501-941-2222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1004 S PINE ST",
            "city": "CABOT",
            "state": "AR",
            "postal_code": "720233865",
            "telephone_number": "501-941-2222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHWAB",
        "first_name": "AIRIELL",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-15",
        "last_updated": "2016-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "AR",
            "license": "2600",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE DMERC REGION C",
            "identifier": "0215420001",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "180288722",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE DMERC",
            "identifier": "1053417360",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAIL ROAD MEDICARE",
            "identifier": "P00806907",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cabot, AR

Sources for this page

Verify at the official NPI Registry.