Individual provider Active NPI

William Fix, O.D.

  • Optometrist
  • Herrin, IL
National Provider Identifier
1285621656
Registry record updated Oct 1, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
046-007446 Issued in IL
Practice address
321 S Park Ave
Herrin, IL 62948-3603
Phone
(618) 942-2900
Fax
(618) 942-4199
NPI assigned
Sep 30, 2005
Last updated
Oct 1, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 1, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 046-007446 IL Primary

Addresses

Primary practice location

321 S Park Ave
Herrin, IL 62948-3603

Mailing address

1200 W Deyoung St
Marion, IL 62959-4437
Phone (618) 993-5686

Other identifiers 8

IdentifierTypeStateIssuer
0814870001OtherILMEDICARE NSC NUMBER
0814870007OtherILMEDICARE NSC NUMBER
046007446MedicaidIL
237369OtherHARMONY HEALTH PLAN
410039812OtherILMEDICARE RAILROAD
IL7446OtherEYEMED
051353OtherHEALTH ALLIANCE
0814870019OtherILMEDICARE NSC NUMBER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100610000393 IL Practitioner - Optometry 7214067750 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Illinois College of Optometry at Chicago, 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Marion Eye Centers LTDGroup PAC ID 3072426774, 38 clinicians

Practice addresses (Care Compare)

321 S Park Ave
Herrin, IL 62948-3603
Phone (618) 942-2900

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
046-007446ILMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Marion Eye Centers LTD. Optometrist CurrentSince May 4, 1999 Accepting new patients
Marion Eye Centers LTD. Optometrist CurrentSince May 4, 1999 Accepting new patients

Locations

321 S Park Ave
Herrin, IL 62948
Phone (618) 942-2900

1200 W Deyoung St
Marion, IL 62959
Phone 61899356861290

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1128038400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1222819200000",
    "number": "1285621656",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 W DEYOUNG ST",
            "city": "MARION",
            "state": "IL",
            "postal_code": "629594437",
            "telephone_number": "618-993-5686",
            "fax_number": "618-997-6250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "321 S PARK AVE",
            "city": "HERRIN",
            "state": "IL",
            "postal_code": "629483603",
            "telephone_number": "618-942-2900",
            "fax_number": "618-942-4199"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FIX",
        "first_name": "WILLIAM",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-30",
        "last_updated": "2008-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046-007446",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE NSC NUMBER",
            "identifier": "0814870001",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE NSC NUMBER",
            "identifier": "0814870007",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "046007446",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HARMONY HEALTH PLAN",
            "identifier": "237369",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "410039812",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EYEMED",
            "identifier": "IL7446",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH ALLIANCE",
            "identifier": "051353",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE NSC NUMBER",
            "identifier": "0814870019",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Herrin, IL

Sources for this page

Verify at the official NPI Registry.