Active NPI
Coleman Cataract and Eye Laser Surgery Center, Inc.
- Anesthesiology Physician
- Greenwood, MS
National Provider Identifier
1245480482
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anesthesiology Physician
- License
- R792327
- 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
- Organization subpart
- No
NPPES NPI Registry
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Anesthesiology Physician | 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 ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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).
-
- Ophthalmologic Surgery Clinic/Center
- Greenwood, MS
- NPI 1639177751
5890863039
National Provider Directory
National Provider Directory- Tax ID family
- Coleman Cataract and Eye Laser Surgery Center Inc
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Ophthalmologic Surgery Clinic/Center
- Greenwood, MS
- NPI 1639177751
Locations
2005 Highway 82 W
Greenwood, MS 38930
Phone (662) 455-3790
Practitioners & affiliated clinicians
Practitioners 3
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
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
- April M. Castle, M.P.T.
- Central Mississippi Radiology
- Circle of Life Adult Day Center
- Rekeeda Latrice Cockhren
- Coleman Cataract and Eye Laser Surgery Center, Inc
- Coleman Eye Center, PLLC
- Kerri Deanetra Coleman, PCMHT
- Lee Walker Coleman, M.D.
- Brenda Collins, NCC, LPC
- Marcella Renee Collins, MSN, FNP-C
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.