Bobby C Pankey, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

V07073 Issued in MS

Practice address

115 Cynthia St
Clinton, MS 39056-3711

Phone

(601) 924-4444

Fax

(601) 924-4100

NPI assigned

May 20, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MS

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

Specialty

Optometry

Education

Southern College of Optometry, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Optical 2000Group PAC ID 8729983325, 4 clinicians

Optical 2000 of RichlandGroup PAC ID 1456439082, 4 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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

• Optical 2000

  • Optometrist
  • Clinton, MS
  • NPI 1144422577
  Medicare reassignment Care Compare group NPD Authorized official
• Optical 2000 of Richland

  • Optometrist
  • Richland, MS
  • NPI 1205001005
  Medicare reassignment Care Compare group Authorized official

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

{
    "created_epoch": "1148083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594944000000",
    "number": "1235183617",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 CYNTHIA ST",
            "city": "CLINTON",
            "state": "MS",
            "postal_code": "390563711",
            "telephone_number": "601-924-4444",
            "fax_number": "601-924-4100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 CYNTHIA ST",
            "city": "CLINTON",
            "state": "MS",
            "postal_code": "390563711",
            "telephone_number": "601-924-4444",
            "fax_number": "601-924-4100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PANKEY",
        "first_name": "BOBBY",
        "middle_name": "C",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-20",
        "last_updated": "2020-07-17",
        "certification_date": "2020-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MS",
            "license": "V07073",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03156827",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tonia Rene Owens
• Jada Palmer
• Jakayla Palmer
• Palmetto Senior Care
• Walter Pang, O.D.
• Dillon J Pankey, OD
• Park Dental Group - Clinton PLLC
• Jessica Parker, PTA
• David King Parks, DMD
• Tracy Denise Parsons

• Optometrist in Clinton, MS
• Providers in Clinton, MS by specialty
• Optometrist in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.