NPIMap

Organization Active NPI

Northeast Eye Care PA

  • Optometrist
  • Madison, MS
National Provider Identifier
1154798692
Registry record updated Dec 22, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
523 Issued in MS
Legal business name
NORTHEAST EYE CARE PA
Practice address
111 Colony Crossing Way
Ste 220
Madison, MS 39110-7778
Phone
(601) 605-4402
Fax
(601) 605-4457
NPI assigned
Sep 1, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 22, 2015

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

Authorized official

Name
Dr. Hal E Hill Jr., O.D.NPI 1790841393
Title
Owner
Phone
(601) 605-4402

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 523 MS Primary

Addresses

Primary practice location

111 Colony Crossing Way
Ste 220
Madison, MS 39110-7778

Mailing address

111 Colony Crossing Way
Ste 220
Madison, MS 39110-7778
Phone (601) 605-4402

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20151223000283 MS Part B Supplier - Clinic/Group Practice 5395046007 Receives reassigned benefits from 2 practitioners
Practice locations: Madison, MS

National Provider Directory

National Provider Directory

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": "1441065600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1450742400000",
    "number": "1154798692",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 COLONY CROSSING WAY",
            "address_2": "STE 220",
            "city": "MADISON",
            "state": "MS",
            "postal_code": "391107778",
            "telephone_number": "601-605-4402",
            "fax_number": "601-605-4457"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 COLONY CROSSING WAY",
            "address_2": "STE 220",
            "city": "MADISON",
            "state": "MS",
            "postal_code": "391107778",
            "telephone_number": "601-605-4402",
            "fax_number": "601-605-4457"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHEAST EYE CARE PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-09-01",
        "last_updated": "2015-12-22",
        "status": "A",
        "authorized_official_last_name": "HILL",
        "authorized_official_first_name": "HAL",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "601-605-4402",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "MS",
            "license": "523",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Madison, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2015; 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.