Clear Vision Eye Care PC

Primary specialty

OptometristTaxonomy code 152W00000X

License

2653 Issued in AR

Legal business name

CLEAR VISION EYE CARE PC

Practice address

3700 E Main St
Blytheville, AR 72315-6881

Phone

(870) 762-0711

NPI assigned

Oct 3, 2012

Organization subpart

No

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

Authorized official

Name

Dr. Kelly Lu, O.D.

Title

Optometrist

Phone

(870) 762-0711

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1349222400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1349222400000",
    "number": "1306198148",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3700 E MAIN ST",
            "city": "BLYTHEVILLE",
            "state": "AR",
            "postal_code": "723156881",
            "telephone_number": "870-762-0711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3700 E MAIN ST",
            "city": "BLYTHEVILLE",
            "state": "AR",
            "postal_code": "723156881",
            "telephone_number": "870-762-0711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLEAR VISION EYE CARE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-10-03",
        "last_updated": "2012-10-03",
        "status": "A",
        "authorized_official_last_name": "LU",
        "authorized_official_first_name": "KELLY",
        "authorized_official_title_or_position": "OPTOMETRIST",
        "authorized_official_telephone_number": "870-762-0711",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "AR",
            "license": "2653",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "184803722",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Optometrist in Blytheville, AR
• Providers in Blytheville, AR by specialty
• Optometrist in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2012; 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.