Individual provider Active NPI

John Eric McCall, O.D.

  • Optometrist
  • Texarkana, TX
National Provider Identifier
1174699615
Registry record updated Apr 16, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
6981T Issued in TX
Practice address
4504 Texas Blvd
Texarkana, TX 75503-3027
Phone
(903) 792-3705
Fax
(903) 794-5008
NPI assigned
Nov 27, 2006
Last updated
Apr 16, 2015By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 16, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 6981T TX Primary

Addresses

Primary practice location

4504 Texas Blvd
Texarkana, TX 75503-3027

Mailing address

4504 Texas Blvd
Texarkana, TX 75503-3027
Phone (903) 792-3705

Other identifiers 1

IdentifierTypeStateIssuer
194776722MedicaidAR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080402000464 TX Practitioner - Optometry 8224115118 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Indiana University - School of Optometry, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Phillips Vision LLCGroup PAC ID 8628265949, 5 clinicians

Practice addresses (Care Compare)

4504 Texas Blvd
Texarkana, TX 75503-3027
Phone (903) 792-3705

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery21

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6981TXMDChiropractor
6981TTXMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Phillips Vision LLC Optometrist CurrentSince Mar 24, 2011 Accepting new patients

Locations

4109 Moores Ln
Texarkana, TX 75503
Phone (903) 329-5051

4504 Texas Blvd
Texarkana, TX 75503
Phone (903) 792-3705

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1164585600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1429142400000",
    "number": "1174699615",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4504 TEXAS BLVD",
            "city": "TEXARKANA",
            "state": "TX",
            "postal_code": "755033027",
            "telephone_number": "903-792-3705"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4504 TEXAS BLVD",
            "city": "TEXARKANA",
            "state": "TX",
            "postal_code": "755033027",
            "telephone_number": "903-792-3705",
            "fax_number": "903-794-5008"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCALL",
        "first_name": "JOHN",
        "middle_name": "ERIC",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-27",
        "last_updated": "2015-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "6981T",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "194776722",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Texarkana, TX

Sources for this page

Verify at the official NPI Registry.