Envision Eye Care, Inc

Primary specialty

OptometristTaxonomy code 152W00000X

License

658 Issued in MS

Legal business name

ENVISION EYE CARE, INC

Practice address

1316 North State Street
Jackson, MS 39202

Phone

(601) 987-3937

Fax

(601) 987-3922

NPI assigned

Mar 29, 2007

Organization subpart

No

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

Authorized official

Name

Mrs. Tonyatta T. Hairston, O.D.NPI 1295847432

Title

Owner

Phone

(601) 987-3937

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MS

Enrollment records 1

Tax ID family

Envision Eye Care Inc4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

• Envision Eye Care, Inc

  • Optometrist
  • Magee, MS
  • NPI 1326254301
  NPD tax ID
• Envision Eye Care, Inc

  • Health Service Clinic/Center
  • Jackson, MS
  • NPI 1710260310
  NPD tax ID
• Envision Eye Care, Incorporated

  • Optometrist
  • Richland, MS
  • NPI 1447466511
  NPD tax ID

Locations

Practitioners 2

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

• Tonyatta T Hairston, O.D.

  • Optometrist
  • Jackson, MS
  • NPI 1295847432

  MS, Optometrist

  Medicare reassignment NPD Authorized official
• Chaka Chanelle Norwood, O.D.

  • Optometrist
  • Memphis, TN
  • NPI 1356656029
  NPD (past)

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

{
    "created_epoch": "1175126400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1310083200000",
    "number": "1083734867",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1316 NORTH STATE STREET",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "39202",
            "telephone_number": "601-987-3937",
            "fax_number": "601-987-3922"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1316 NORTH STATE STREET",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "39202",
            "telephone_number": "601-987-3937",
            "fax_number": "601-987-3922"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ENVISION EYE CARE, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-29",
        "last_updated": "2011-07-08",
        "status": "A",
        "authorized_official_last_name": "HAIRSTON",
        "authorized_official_first_name": "TONYATTA",
        "authorized_official_middle_name": "T.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "601-987-3937",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "MS",
            "license": "658",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "05254312",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kelly Brooke Engelmann, CFNP
• Enhanced Wellness Living PLLC
• Enhanced Wellness, PLLC
• Julia Enos, D.O.
• Diana L Entrekin, MD
• Envision Eye Care, Inc
• Ep'S on the Go
• Stephen Paul Epperson, MD
• Yolanda Epps, PHYSICAL THERAPIST
• Eps on the Go II

• All providers in Jackson, MS
• Optometrist in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2011; 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.

Verify at the official NPI Registry.