Complete Family Eyecare, PC

Primary specialty

OptometristTaxonomy code 152W00000X

License

046.010332 Issued in IL

Legal business name

COMPLETE FAMILY EYECARE, PC

Practice address

3121 S Park Ave
Herrin, IL 62948-3785

Phone

(618) 942-5465

Fax

(618) 942-7042

NPI assigned

Aug 15, 2010

Last updated

Jul 25, 2019By 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

Dr. Chase A Rudolph, O.D.NPI 1457663809

Title

President

Phone

(618) 942-5465

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Locations

Practitioners 5

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.

• Chase Aaron Rudolph, O.D.

  • Optometrist
  • Herrin, IL
  • NPI 1457663809
  Medicare reassignment Care Compare group NPD Authorized official
• Andrew Thomas Dust, OD

  • Optometrist
  • Herrin, IL
  • NPI 1790523488
  Medicare reassignment Care Compare group NPD
• Lexie McKenna Peper, OD

  • Optometrist
  • Carbondale, IL
  • NPI 1346975620
  Medicare reassignment Care Compare group NPD
• Madyson Nicole Carruthers, OD

  • Optometrist
  • Marion, IL
  • NPI 1639854359
  Medicare reassignment NPD
• Teresa Myers, O.D.

  • Optometrist
  • West Frankfort, IL
  • NPI 1225197148
  Medicare reassignment NPD

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

{
    "created_epoch": "1281830400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1564012800000",
    "number": "1104131168",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2813 S PARK AVE",
            "city": "HERRIN",
            "state": "IL",
            "postal_code": "629483700",
            "telephone_number": "618-942-5465",
            "fax_number": "618-942-7042"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3121 S PARK AVE",
            "city": "HERRIN",
            "state": "IL",
            "postal_code": "629483785",
            "telephone_number": "618-942-5465",
            "fax_number": "618-942-7042"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMPLETE FAMILY EYECARE, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-08-15",
        "last_updated": "2019-07-25",
        "status": "A",
        "authorized_official_last_name": "RUDOLPH",
        "authorized_official_first_name": "CHASE",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "618-942-5465",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046.010332",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jaime Ann Clark, PH.D.
• Tiffany Colborn, NP
• Jennifer Ann Colboth, M.P.T.
• Carrie Collins, MS SLP
• Elaine B Combs, DEVELOPMENTAL THERAP
• David Stefan Constantinescu, MD
• Erik Cornett
• Michael Cosimi, D.M.D., M.S.
• Erica Cowan, MSW
• Scott Wesley Cranick, PA-C

• Optometrist in Herrin, IL
• Providers in Herrin, IL by specialty
• Optometrist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2019; 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.