NPIMap

Organization Active NPI

John H McDougall OD PC

Doing business as Eyecare Specialties

  • Optometrist
  • Beatrice, NE
National Provider Identifier
1154894608
Registry record updated Sep 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
JOHN H MCDOUGALL OD PC
Doing business as
Eyecare Specialties
Practice address
2005 Court St
Beatrice, NE 68310-3210
Phone
(402) 420-2020
Fax
(402) 223-5286
NPI assigned
Jan 8, 2019
Last updated
Sep 9, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2024

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

Authorized official

Name
Melissa Allison
Title
Credentialing Contact
Phone
(314) 741-8183

Specialties & licenses 1

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

Addresses

Primary practice location

2005 Court St
Beatrice, NE 68310-3210

Mailing address

111 E 4TH St Ste 440
Alton, IL 62002-6206
Phone (618) 462-9818

Other names 1

  • Eyecare Specialties Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190306001220 NE Part B Supplier - Clinic/Group Practice 4587903786 Receives reassigned benefits from 22 practitioners
Practice locations: Beatrice, NE; Fremont, NE; Lincoln, NE

National Provider Directory

National Provider Directory

Locations

2917 Pine Lake Rd
Lincoln, NE 68516
Phone (402) 466-9632

Practitioners & affiliated clinicians

Practitioners 22

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.

View all 22

NPI Registry JSON

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

{
    "created_epoch": "1546905600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1725840000000",
    "number": "1154894608",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 E 4TH ST STE 440",
            "city": "ALTON",
            "state": "IL",
            "postal_code": "620026206",
            "telephone_number": "618-462-9818",
            "fax_number": "314-741-4947"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2005 COURT ST",
            "city": "BEATRICE",
            "state": "NE",
            "postal_code": "683103210",
            "telephone_number": "402-420-2020",
            "fax_number": "402-223-5286"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOHN H MCDOUGALL OD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-01-08",
        "last_updated": "2024-09-09",
        "certification_date": "2024-09-09",
        "status": "A",
        "authorized_official_last_name": "ALLISON",
        "authorized_official_first_name": "MELISSA",
        "authorized_official_title_or_position": "CREDENTIALING CONTACT",
        "authorized_official_telephone_number": "314-741-8183"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Eyecare Specialties",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Eyecare Specialties",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Beatrice, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2024; 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.