NPIMap

Organization Active NPI

Kilgore-Gilmer-Eye Care Centers P.a.

  • Optometrist
  • Gilmer, TX
National Provider Identifier
1104335918
Registry record updated Sep 25, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
KILGORE-GILMER-EYE CARE CENTERS P.A.
Practice address
101 Simpson St
Gilmer, TX 75644-2231
Phone
(903) 843-5400
Fax
(903) 843-5101
NPI assigned
Sep 25, 2017
Organization subpart
Yes
Parent organization
KILGORE-GILMER-EYE CARE CENTERS P.A.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 25, 2017

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

Authorized official

Name
Courtney Loper
Title
Billing/Credentialing Specialist
Phone
(903) 983-2020

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X Primary

Addresses

Primary practice location

101 Simpson St
Gilmer, TX 75644-2231

Mailing address

PO Box 8000
Kilgore, TX 75663-8000
Phone (903) 983-2020

Other identifiers 1

IdentifierTypeStateIssuer
0193690-01MedicaidTX

Other names 1

  • Gilmer Eye Care Center Doing business as

National Provider Directory

National Provider Directory
Part of
Kilgore-Gilmer-Eye Care Centers PA

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 4

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

NPI Registry JSON

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

{
    "created_epoch": "1506297600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1506297600000",
    "number": "1104335918",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 8000",
            "city": "KILGORE",
            "state": "TX",
            "postal_code": "756638000",
            "telephone_number": "903-983-2020",
            "fax_number": "903-984-1567"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 SIMPSON ST",
            "city": "GILMER",
            "state": "TX",
            "postal_code": "756442231",
            "telephone_number": "903-843-5400",
            "fax_number": "903-843-5101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KILGORE-GILMER-EYE CARE CENTERS P.A.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "KILGORE-GILMER-EYE CARE CENTERS P.A.",
        "enumeration_date": "2017-09-25",
        "last_updated": "2017-09-25",
        "status": "A",
        "authorized_official_last_name": "LOPER",
        "authorized_official_first_name": "COURTNEY",
        "authorized_official_title_or_position": "BILLING/CREDENTIALING SPECIALIST",
        "authorized_official_telephone_number": "903-983-2020"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0193690-01",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Gilmer Eye Care Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Gilmer, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2017; 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.