NPIMap

Organization Active NPI

Looking Glass Eye Center PA

  • Ophthalmology Physician
  • Brevard, NC
National Provider Identifier
1275592271
Registry record updated Aug 31, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
Legal business name
LOOKING GLASS EYE CENTER PA
Practice address
188 Medical Park Drive
Suite C
Brevard, NC 28712-3035
Phone
(828) 884-7320
Fax
(828) 877-6191
NPI assigned
Mar 20, 2006
Last updated
Aug 31, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 31, 2011

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

Authorized official

Name
Donna Phillips
Title
Administrator
Phone
(828) 884-7320

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X NC
Ophthalmology Physician 207W00000X NC Primary

Addresses

Primary practice location

188 Medical Park Drive
Suite C
Brevard, NC 28712-3035

Mailing address

188 Medical Park Dr
Suite C
Brevard, NC 28712-3035
Phone (828) 884-7320

Other identifiers 2

IdentifierTypeStateIssuer
890195GMedicaidNC
CK8048OtherNCMEDICARE RAILROAD

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040611000990 NC Part B Supplier - Clinic/Group Practice 6901889617 Receives reassigned benefits from 6 practitioners
Practice locations: Hendersonville, NC; Brevard, NC

Other NPIs with the same Medicare PAC ID 2

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

National Provider Directory

National Provider Directory
Tax ID family
Looking Glass Eye Center PA3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

Locations

1027 Fleming St
Ste B
Hendersonvlle, NC 28791
Phone (828) 693-1100

215 Thompson St
Hendersonvlle, NC 28792
Phone (828) 693-4161

Practitioners & affiliated clinicians

Practitioners 10

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": "1142812800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1314748800000",
    "number": "1275592271",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "188 MEDICAL PARK DR",
            "address_2": "SUITE C",
            "city": "BREVARD",
            "state": "NC",
            "postal_code": "287123035",
            "telephone_number": "828-884-7320",
            "fax_number": "828-877-6191"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "188 MEDICAL PARK DRIVE",
            "address_2": "SUITE C",
            "city": "BREVARD",
            "state": "NC",
            "postal_code": "287123035",
            "telephone_number": "828-884-7320",
            "fax_number": "828-877-6191"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LOOKING GLASS EYE CENTER PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-20",
        "last_updated": "2011-08-31",
        "status": "A",
        "authorized_official_last_name": "PHILLIPS",
        "authorized_official_first_name": "DONNA",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "828-884-7320"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NC",
            "license": null,
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "NC",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "890195G",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "CK8048",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brevard, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2011; 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.