NPIMap

Organization Active NPI

Poarch Band of Creek Indians Dba Premier Family Eye Care

  • Optometrist
  • Atmore, AL
National Provider Identifier
1336257575
Registry record updated Jan 27, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
POARCH BAND OF CREEK INDIANS DBA PREMIER FAMILY EYE CARE
Practice address
5811 Jack Springs Rd
Atmore, AL 36502-5025
Phone
(251) 446-3937
Fax
(251) 368-0805
NPI assigned
Aug 28, 2006
Last updated
Jan 27, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 27, 2017

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

Authorized official

Name
Ms. Eddie Jackson
Title
Health Administrator
Phone
(251) 368-9136

Specialties & licenses 1

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

Addresses

Primary practice location

5811 Jack Springs Rd
Atmore, AL 36502-5025

Mailing address

5811 Jack Springs Rd.
Atmore, AL 36502
Phone (251) 446-3937

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

5811 Jack Springs Rd
Atmore, AL 36502
Phone (251) 368-9136

6044 W Highway 74
Indian Trail, NC 28079
Phone (704) 821-3937

6467 Old Monroe Rd
Ste I
Indian Trail, NC 28079
Phone (704) 821-3937

Practitioners & affiliated clinicians

Practitioners 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1156723200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1485475200000",
    "number": "1336257575",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5811 JACK SPRINGS RD.",
            "city": "ATMORE",
            "state": "AL",
            "postal_code": "36502",
            "telephone_number": "251-446-3937",
            "fax_number": "251-368-0805"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5811 JACK SPRINGS RD",
            "city": "ATMORE",
            "state": "AL",
            "postal_code": "365025025",
            "telephone_number": "251-446-3937",
            "fax_number": "251-368-0805"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "POARCH BAND OF CREEK INDIANS DBA PREMIER FAMILY EYE CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-28",
        "last_updated": "2017-01-27",
        "status": "A",
        "authorized_official_last_name": "JACKSON",
        "authorized_official_first_name": "EDDIE",
        "authorized_official_title_or_position": "HEALTH ADMINISTRATOR",
        "authorized_official_telephone_number": "251-368-9136",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atmore, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2017; 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.