NPIMap

Organization Active NPI

Simmons Eye Clinic, LLC.

  • Ophthalmology Physician
  • Brookhaven, MS
National Provider Identifier
1194858431
Registry record updated Jun 30, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
17670 Issued in MS
Legal business name
SIMMONS EYE CLINIC, LLC.
Practice address
121 S Railroad Ave
Brookhaven, MS 39601-3372
Phone
(601) 823-3098
Fax
(601) 823-3099
NPI assigned
Mar 14, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2010

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

Authorized official

Name
Dr. Eugene Simmons Jr., M.D.
Title
Owner
Phone
(601) 823-3098

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207W00000X 17670 MS Primary

Addresses

Primary practice location

121 S Railroad Ave
Brookhaven, MS 39601-3372

Mailing address

121 S Railroad Ave
Brookhaven, MS 39601-3372
Phone (601) 823-3098

Other identifiers 2

IdentifierTypeStateIssuer
06428569MedicaidMS
06131738MedicaidMS

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1173830400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1277856000000",
    "number": "1194858431",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "121 S RAILROAD AVE",
            "city": "BROOKHAVEN",
            "state": "MS",
            "postal_code": "396013372",
            "telephone_number": "601-823-3098",
            "fax_number": "601-823-3099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "121 S RAILROAD AVE",
            "city": "BROOKHAVEN",
            "state": "MS",
            "postal_code": "396013372",
            "telephone_number": "601-823-3098",
            "fax_number": "601-823-3099"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SIMMONS EYE CLINIC, LLC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-14",
        "last_updated": "2010-06-30",
        "status": "A",
        "authorized_official_last_name": "SIMMONS",
        "authorized_official_first_name": "EUGENE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "601-823-3098",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": "MS",
            "license": "17670",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "06428569",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "06131738",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brookhaven, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.