Organization Active NPI

Lifetime Eye Care, P. C.

  • Optometrist
  • Charleston, IL
National Provider Identifier
1205424900
Registry record updated Dec 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
LIFETIME EYE CARE, P. C.
Practice address
1903 18TH St
Charleston, IL 61920-3612
Phone
(217) 345-6600
Fax
(217) 345-6622
NPI assigned
Jan 7, 2021
Last updated
Dec 23, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 23, 2025

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

Authorized official

Name
Nancy Hendrix
Title
Insurance/Billing
Phone
(217) 345-6600

Specialties & licenses 1

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

Addresses

Primary practice location

1903 18TH St
Charleston, IL 61920-3612

Mailing address

1700 18TH St
Charleston, IL 61920-3607
Phone (217) 345-6600

Other practice location 1

1821 Charleston Ave
Mattoon, IL 61938-3829
Phone (217) 234-6600

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20210809003369 IL Part B Supplier - Clinic/Group Practice 0244634541 Receives reassigned benefits from 3 practitioners
Practice locations: Charleston, IL; Mattoon, IL
O20220425000162 IL DME Supplier - Physician - Optometrist 0244634541 Practice locations: Charleston, IL

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Lifetime Eye Care PC1903 18TH St, Charleston, IL 61920-3612(217) 345-6600 Prosthetic Lenses: Conventional Eyeglasses|Prosthetic Lenses: Conventional Contact Lenses Accepts assignmentParticipating since Jun 25, 2021

National Provider Directory

National Provider Directory

Locations

1903 18th St
Charleston, IL 61920
Phone (217) 345-6600

1821 Charleston Ave
Mattoon, IL 61938
Phone (217) 234-6600

Practitioners & affiliated clinicians

Practitioners 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1609977600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1766448000000",
    "number": "1205424900",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1700 18TH ST",
            "city": "CHARLESTON",
            "state": "IL",
            "postal_code": "619203607",
            "telephone_number": "217-345-6600",
            "fax_number": "217-345-6622"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1903 18TH ST",
            "city": "CHARLESTON",
            "state": "IL",
            "postal_code": "619203612",
            "telephone_number": "217-345-6600",
            "fax_number": "217-345-6622"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1821 Charleston Ave",
            "address_purpose": "LOCATION",
            "city": "Mattoon",
            "state": "IL",
            "postal_code": "619383829",
            "country_code": "US",
            "telephone_number": "217-234-6600",
            "fax_number": "217-234-6622",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "LIFETIME EYE CARE, P. C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-01-07",
        "last_updated": "2025-12-23",
        "certification_date": "2025-12-23",
        "status": "A",
        "authorized_official_last_name": "HENDRIX",
        "authorized_official_first_name": "NANCY",
        "authorized_official_title_or_position": "INSURANCE/BILLING",
        "authorized_official_telephone_number": "217-345-6600"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charleston, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.