Cockrum Vision Clinic

Primary specialty

OptometristTaxonomy code 152W00000X

License

AR2230 Issued in AR

Legal business name

COCKRUM VISION CLINIC

Practice address

2183 Highway 62 W
Mountain Home, AR 72653-6500

Phone

(870) 425-1112

Fax

(870) 425-1278

NPI assigned

Jul 2, 2009

Organization subpart

No

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

Authorized official

Name

Bernadina C. Paine

Title

Office Manager

Phone

(870) 425-1112

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1246492800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1449619200000",
    "number": "1265661938",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2183 HIGHWAY 62 W",
            "city": "MOUNTAIN HOME",
            "state": "AR",
            "postal_code": "726536500",
            "telephone_number": "870-425-1112",
            "fax_number": "870-425-1278"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2183 HIGHWAY 62 W",
            "city": "MOUNTAIN HOME",
            "state": "AR",
            "postal_code": "726536500",
            "telephone_number": "870-425-1112",
            "fax_number": "870-425-1278"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COCKRUM VISION CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-07-02",
        "last_updated": "2015-12-09",
        "status": "A",
        "authorized_official_last_name": "PAINE",
        "authorized_official_first_name": "BERNADINA",
        "authorized_official_middle_name": "C.",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "870-425-1112"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "AR",
            "license": "AR2230",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110615722",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Cmnrc, Inc.
• Jennifer Coan
• Heather Cobb
• Jessica Coble, LMSW, RBT
• Aaron Cole Cochran
• Melissa G Coker
• Sydney Elizabeth Colbert
• Bradley Wayne Coleman, D.D.S.
• Leah Coleman
• Jenna Collins, LCSW

• Optometrist in Mountain Home, AR
• Providers in Mountain Home, AR by specialty
• Optometrist in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2015; 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.