NPIMap

Organization Active NPI

Southern Eye Associates, LTD

  • Optometrist
  • Walnut Ridge, AR
National Provider Identifier
1215025119
Registry record updated Jul 23, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2125 Issued in AR
Legal business name
SOUTHERN EYE ASSOCIATES, LTD
Practice address
1014 W Main St
Walnut Ridge, AR 72476-1004
Phone
(870) 886-2632
Fax
(870) 886-1514
NPI assigned
Oct 10, 2006
Last updated
Jul 23, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2008

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

Authorized official

Name
John T McHaneyNPI 1295822708
Title
O.D.
Phone
(870) 886-2632

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
OptometristGroup: 193200000X MULTI-SPECIALTY GROUP 152W00000X 2125 AR Primary

Addresses

Primary practice location

1014 W Main St
Walnut Ridge, AR 72476-1004

Mailing address

PO Box 88
Walnut Ridge, AR 72476-0088
Phone (870) 886-2632

Other identifiers 1

IdentifierTypeStateIssuer
102555722MedicaidAR

Other names 1

  • MCHANEY VISION CENTER Other name

National Provider Directory

National Provider Directory
Tax ID family
Barry L Harris OD2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Practitioners & affiliated clinicians

Practitioners 4

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": "1160438400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1216771200000",
    "number": "1215025119",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 88",
            "city": "WALNUT RIDGE",
            "state": "AR",
            "postal_code": "724760088",
            "telephone_number": "870-886-2632",
            "fax_number": "870-886-1514"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1014 W MAIN ST",
            "city": "WALNUT RIDGE",
            "state": "AR",
            "postal_code": "724761004",
            "telephone_number": "870-886-2632",
            "fax_number": "870-886-1514"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN EYE ASSOCIATES, LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-10",
        "last_updated": "2008-07-23",
        "status": "A",
        "authorized_official_last_name": "MCHANEY",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "O.D.",
        "authorized_official_telephone_number": "870-886-2632"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": "AR",
            "license": "2125",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "102555722",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MCHANEY VISION CENTER",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Walnut Ridge, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2008; 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.