Madison Eye Care Clinic

Primary specialty

Health Maintenance OrganizationTaxonomy code 302R00000X

License

641 Issued in MS

Legal business name

MADISON EYE CARE CLINIC

Practice address

2168 Main St
Suite a
Madison, MS 39110-6319

Phone

(601) 605-9885

Fax

(601) 605-9815

NPI assigned

Oct 5, 2006

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Cassandra Leigh Clements, O.D.

Title

Optometry

Phone

(601) 605-9885

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

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

{
    "created_epoch": "1160006400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1275629594",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2168 MAIN ST",
            "address_2": "SUITE A",
            "city": "MADISON",
            "state": "MS",
            "postal_code": "391106319",
            "telephone_number": "601-605-9885",
            "fax_number": "601-605-9815"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2168 MAIN ST",
            "address_2": "SUITE A",
            "city": "MADISON",
            "state": "MS",
            "postal_code": "391106319",
            "telephone_number": "601-605-9885",
            "fax_number": "601-605-9815"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MADISON EYE CARE CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-05",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "CLEMENTS",
        "authorized_official_first_name": "CASSANDRA",
        "authorized_official_middle_name": "LEIGH",
        "authorized_official_title_or_position": "OPTOMETRY",
        "authorized_official_telephone_number": "601-605-9885",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "302R00000X",
            "taxonomy_group": "",
            "desc": "Health Maintenance Organization",
            "state": "MS",
            "license": "641",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "P00059148",
            "identifier": "PALMETTO GBA",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00880188",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Madison Dental Studio
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• Madison Foot Clinic, PLLC
• Madison General Surgery, PLLC
• Madison Healthplex & Sports Performance Center LLC
• Madison Healthplex and Sports Performance Center LLC (Madison Healthplex Performance Training Center)
• Madison Imaging LLC (dba Madison Medical Imaging)

• Health Maintenance Organization in Madison, MS
• Providers in Madison, MS by specialty
• Health Maintenance Organization in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.