NPIMap

Organization Active NPI

Coleman Cataract and Eye Laser Surgery Center, Inc.

  • Anesthesiology Physician
  • Greenwood, MS
National Provider Identifier
1245480482
Registry record updated Sep 24, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
R792327 Issued in MS
Legal business name
COLEMAN CATARACT AND EYE LASER SURGERY CENTER, INC.
Practice address
2005 Hwy 82 W
Greenwood, MS 38930
Phone
(662) 455-4523
Fax
(662) 455-3790
NPI assigned
Sep 24, 2008
Last updated
Sep 24, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2008

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

Authorized official

Name
Amy Bush
Title
RN/Administrator
Phone
(662) 455-4523

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207L00000X R792327 MS Primary
Ophthalmologic Surgery Clinic/Center 261QS0132X

Addresses

Primary practice location

2005 Hwy 82 W
Greenwood, MS 38930

Mailing address

2005 Hwy 82 W
Greenwood, MS 38930
Phone (662) 455-4523

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20081001000480 MS Part B Supplier - Clinic/Group Practice 5890863039 Receives reassigned benefits from 3 practitioners
Practice locations: Greenwood, MS

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Coleman Cataract and Eye Laser Surgery Center Inc2 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": "1222214400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1222214400000",
    "number": "1245480482",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2005 HWY 82 W",
            "city": "GREENWOOD",
            "state": "MS",
            "postal_code": "38930",
            "telephone_number": "662-455-4523",
            "fax_number": "662-455-3790"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2005 HWY 82 W",
            "city": "GREENWOOD",
            "state": "MS",
            "postal_code": "38930",
            "telephone_number": "662-455-4523",
            "fax_number": "662-455-3790"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLEMAN CATARACT AND EYE LASER SURGERY CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-09-24",
        "last_updated": "2008-09-24",
        "status": "A",
        "authorized_official_last_name": "BUSH",
        "authorized_official_first_name": "AMY",
        "authorized_official_title_or_position": "RN/ADMINISTRATOR",
        "authorized_official_telephone_number": "662-455-4523"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Anesthesiology",
            "state": "MS",
            "license": "R792327",
            "primary": true
        },
        {
            "code": "261QS0132X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ophthalmologic Surgery",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenwood, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.