NPIMap

Organization Active NPI

Four Corners Eye Clinic, PC

  • Specialist
  • Durango, CO
National Provider Identifier
1164595658
Registry record updated Feb 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
FOUR CORNERS EYE CLINIC, PC
Practice address
575 Rivergate
Suite 212
Durango, CO 81301-7487
Phone
(970) 259-2202
Fax
(970) 259-2837
NPI assigned
Nov 15, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 3, 2024

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

Authorized official

Name
Eric C Meyer, M.D.NPI 1003989633
Title
Physician Managing Partner
Phone
(970) 259-2202

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
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X Primary

Addresses

Primary practice location

575 Rivergate
Suite 212
Durango, CO 81301-7487

Mailing address

575 Rivergate Unit 212
Durango, CO 81301-7488
Phone (970) 259-2202

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO, NM2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040329000385 CO Part B Supplier - Clinic/Group Practice 1658263173 Receives reassigned benefits from 6 practitioners
2 other NPIs on this enrollment
Practice locations: Cortez, CO; Durango, CO; Pagosa Springs, CO
O20190226003014 NM Part B Supplier - Clinic/Group Practice 1658263173 Receives reassigned benefits from 1 practitioner
Practice locations: Aztec, NM

Other NPIs on the same Medicare enrollment 2

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

National Provider Directory

National Provider Directory
Tax ID family
John M Parkinson MD3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

Locations

575 Rivergate Ln
Durango, CO 81301
Phone (719) 648-5678

575 Rivergate Ln
Unit 212
Durango, CO 81301
Phone (970) 259-2202

121 S Main Ave
Aztec, NM 87410
Phone (505) 333-7278

Ownership & related parties

Subparts reporting this organization as parent 2

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 6

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": "1163548800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1706918400000",
    "number": "1164595658",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "575 RIVERGATE UNIT 212",
            "city": "DURANGO",
            "state": "CO",
            "postal_code": "813017488",
            "telephone_number": "970-259-2202",
            "fax_number": "970-259-2837"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "575 RIVERGATE",
            "address_2": "SUITE 212",
            "city": "DURANGO",
            "state": "CO",
            "postal_code": "813017487",
            "telephone_number": "970-259-2202",
            "fax_number": "970-259-2837"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOUR CORNERS EYE CLINIC, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-15",
        "last_updated": "2024-02-03",
        "certification_date": "2024-02-03",
        "status": "A",
        "authorized_official_last_name": "MEYER",
        "authorized_official_first_name": "ERIC",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "PHYSICIAN MANAGING PARTNER",
        "authorized_official_telephone_number": "970-259-2202",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Durango, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 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.