Eye Surgery Consultants LLC

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

Legal business name

EYE SURGERY CONSULTANTS LLC

Doing business as

Eye Surgery Consultants

Practice address

2530 Lucy Lee Pkwy
Poplar Bluff, MO 63901-2436

Phone

(573) 686-4800

NPI assigned

Sep 16, 2020

Last updated

Sep 16, 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

Robert Porter Smith, M.D.NPI 1134190416

Title

M.D.

Phone

(573) 686-4800

Specialties & licenses 2

Addresses

Other names 1

• Eye Surgery Consultants Doing business as

Medicare fee-for-service enrollment

Enrolled in MO

Enrollment records 1

Locations

Practitioners 4

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.

• Robert Porter Smith, M.D.

  • Ophthalmology Physician
  • Poplar Bluff, MO
  • NPI 1134190416
  Medicare reassignment NPD Authorized official
• Cassidy Obermark, O.D.

  • Optometrist
  • Sikeston, MO
  • NPI 1841546074
  Medicare reassignment NPD
• Daniel Robert Obermark, O.D.

  • Optometrist
  • Sikeston, MO
  • NPI 1194709220
  Medicare reassignment NPD
• Kayla S Melton, O.D.

  • Optometrist
  • Poplar Bluff, MO
  • NPI 1003867243
  NPD (past)

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

{
    "created_epoch": "1600214400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1600214400000",
    "number": "1316553373",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2530 LUCY LEE PKWY",
            "city": "POPLAR BLUFF",
            "state": "MO",
            "postal_code": "639012436",
            "telephone_number": "573-686-4800",
            "fax_number": "573-686-8448"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2530 LUCY LEE PKWY",
            "city": "POPLAR BLUFF",
            "state": "MO",
            "postal_code": "639012436",
            "telephone_number": "573-686-4800"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1231 1st St Ste 1",
            "address_purpose": "LOCATION",
            "city": "Kennett",
            "state": "MO",
            "postal_code": "638572521",
            "country_code": "US",
            "telephone_number": "573-888-3335",
            "fax_number": "573-888-0247",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1250 N Main St",
            "address_purpose": "LOCATION",
            "city": "Sikeston",
            "state": "MO",
            "postal_code": "638014827",
            "country_code": "US",
            "telephone_number": "573-471-1080",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "EYE SURGERY CONSULTANTS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-09-16",
        "last_updated": "2020-09-16",
        "certification_date": "2020-09-16",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "PORTER",
        "authorized_official_title_or_position": "M.D.",
        "authorized_official_telephone_number": "573-686-4800",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Eye Surgery Consultants",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Eugene C Hansbrough, MD LLC
• Catherine Evans
• Cody Eveland
• Karl James Ewert, DPM
• Executive Pulmonary Medicine, PC
• Eye Surgery Consultants, LLP
• Kathleen L Fain
• Clea Marie Fairaizl, LCSW
• Michael Scott Fairlamb
• Roger Dean Faltys, CRNA

• Ophthalmology Physician in Poplar Bluff, MO
• Providers in Poplar Bluff, MO by specialty
• Ophthalmology Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2020; 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.