Primary Eye Care Associates

Primary specialty

Preferred Provider OrganizationTaxonomy code 305R00000X

License

T02701 Issued in MO

Legal business name

PRIMARY EYE CARE ASSOCIATES

Practice address

303 Teaco Rd
Kennett, MO 63857-3237

Phone

(573) 888-5896

Fax

(573) 888-1501

NPI assigned

Jan 30, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Merrill Thomas Miller, O.D.

Title

Owner

Phone

(573) 888-5896

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

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

{
    "created_epoch": "1170115200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1053458380",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "303 TEACO RD",
            "city": "KENNETT",
            "state": "MO",
            "postal_code": "638573237",
            "telephone_number": "573-888-5896",
            "fax_number": "573-888-1501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "303 TEACO RD",
            "city": "KENNETT",
            "state": "MO",
            "postal_code": "638573237",
            "telephone_number": "573-888-5896",
            "fax_number": "573-888-1501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIMARY EYE CARE ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-30",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MILLER",
        "authorized_official_first_name": "MERRILL",
        "authorized_official_middle_name": "THOMAS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "573-888-5896",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "305R00000X",
            "taxonomy_group": "",
            "desc": "Preferred Provider Organization",
            "state": "MO",
            "license": "T02701",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "191843",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA GOVERNMENT",
            "identifier": "5514370001",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Preferred Provider Organization in Kennett, MO
• Providers in Kennett, MO by specialty
• Preferred Provider Organization in Missouri

• 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.