NPIMap

Organization Active NPI

Eye Surgeons of Richmond, Inc.

  • Optometrist
  • Midlothian, VA
National Provider Identifier
1124396981
Registry record updated Oct 24, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
EYE SURGEONS OF RICHMOND, INC.
Practice address
611 Watkins Centre Pkwy
Suite 100
Midlothian, VA 23114-4404
Phone
(804) 287-7420
Fax
(804) 287-4210
NPI assigned
Dec 8, 2011
Organization subpart
Yes
Parent organization
VIRGINIA EYE INSTITUTEAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 24, 2012

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

Authorized official

Name
Mr. Eddie F Clark
Title
Chief Financial Officer
Phone
(804) 287-4236

Specialties & licenses 1

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

Addresses

Primary practice location

611 Watkins Centre Pkwy
Suite 100
Midlothian, VA 23114-4404

Mailing address

400 Westhampton Sta
Richmond, VA 23226-3330
Phone (804) 287-4200

Other names 1

  • Virignia Eye Institute Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040407001285 VA Part B Supplier - Clinic/Group Practice 5799778320 Receives reassigned benefits from 48 practitioners
8 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Mechanicsville, VA; Richmond, VA; Prince George, VA; Henrico, VA; Chester, VA; Midlothian, VA
O20120627000739 VA DME Supplier - Physician - Ophthalmology 5799778320 Practice locations: Midlothian, VA

Other NPIs with the same Medicare PAC ID 4

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 8

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Eye Surgeons of Richmond4 organizations share this tax ID, including this one
Part of
Eye Surgeons of Richmond

Other organizations with this tax ID 3

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

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 2

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": "1323302400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1351036800000",
    "number": "1124396981",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 WESTHAMPTON STA",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232263330",
            "telephone_number": "804-287-4200",
            "fax_number": "804-287-4210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "611 WATKINS CENTRE PKWY",
            "address_2": "SUITE 100",
            "city": "MIDLOTHIAN",
            "state": "VA",
            "postal_code": "231144404",
            "telephone_number": "804-287-7420",
            "fax_number": "804-287-4210"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EYE SURGEONS OF RICHMOND, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "VIRGINIA EYE INSTITUTE",
        "enumeration_date": "2011-12-08",
        "last_updated": "2012-10-24",
        "status": "A",
        "authorized_official_last_name": "CLARK",
        "authorized_official_first_name": "EDDIE",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "804-287-4236",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Virignia Eye Institute",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Midlothian, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2012; 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.