NPIMap

Organization Active NPI

Family Eye Care of Russellville

  • Optometrist
  • Russellville, AR
National Provider Identifier
1326195181
Registry record updated Feb 21, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2484 Issued in AR
Legal business name
FAMILY EYE CARE OF RUSSELLVILLE
Practice address
2409 E Main St
Russellville, AR 72802-9619
Phone
(479) 967-0600
NPI assigned
Jan 4, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 21, 2012

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

Authorized official

Name
Mrs. Anne Margaret Snider, ODNPI 1073582391
Title
Owner
Phone
(479) 967-0600

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 2484 AR Primary

Addresses

Primary practice location

2409 E Main St
Russellville, AR 72802-9619

Mailing address

2409 E Main St
Russellville, AR 72802-9619
Phone (479) 967-0600

Other identifiers 1

IdentifierTypeStateIssuer
5C326OtherARCLINIC NUMBER

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060109000078 AR Part B Supplier - Clinic/Group Practice 4082637814 Receives reassigned benefits from 3 practitioners
Practice locations: Russellville, AR

National Provider Directory

National Provider Directory

Locations

2409 E Main St
Russellville, AR 72802
Phone (479) 967-0600

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1167868800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1329782400000",
    "number": "1326195181",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2409 E MAIN ST",
            "city": "RUSSELLVILLE",
            "state": "AR",
            "postal_code": "728029619",
            "telephone_number": "479-967-0600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2409 E MAIN ST",
            "city": "RUSSELLVILLE",
            "state": "AR",
            "postal_code": "728029619",
            "telephone_number": "479-967-0600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY EYE CARE OF RUSSELLVILLE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-04",
        "last_updated": "2012-02-21",
        "status": "A",
        "authorized_official_last_name": "SNIDER",
        "authorized_official_first_name": "ANNE",
        "authorized_official_middle_name": "MARGARET",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "479-967-0600",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "AR",
            "license": "2484",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLINIC NUMBER",
            "identifier": "5C326",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Russellville, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2012; 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.