Individual provider Active NPI

Carol Esther Vanscyoc, O.D.

  • Optometrist
  • Fayetteville, AR
National Provider Identifier
1346220001
Registry record updated Jul 16, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2304 Issued in AR
Practice address
741 E Van Asche Dr
Fayetteville, AR 72703
Phone
(479) 442-5227
Fax
(479) 582-4952
NPI assigned
Jan 19, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2304 AR Primary

Addresses

Primary practice location

741 E Van Asche Dr
Fayetteville, AR 72703

Mailing address

741 E Van Asche Dr
Fayetteville, AR 72703-4916
Phone (479) 442-5227

Other identifiers 2

IdentifierTypeStateIssuer
49363OtherARBLUE CROSS PROVIDER
15666000040OtherARQUALCHOICE PROVIDER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2304ARMDPediatric Physical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Lakeside Surgery Center, LLC CurrentSince Jul 9, 2025 Accepting new patients

Locations

741 E Van Asche Dr
Fayetteville, AR 72703
Phone 47942252271208

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1137628800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1531699200000",
    "number": "1346220001",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "741 E VAN ASCHE DR",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727034916",
            "telephone_number": "479-442-5227",
            "fax_number": "479-582-4952"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "741 E VAN ASCHE DR",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "72703",
            "telephone_number": "479-442-5227",
            "fax_number": "479-582-4952"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANSCYOC",
        "first_name": "CAROL",
        "middle_name": "ESTHER",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-19",
        "last_updated": "2018-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "AR",
            "license": "2304",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS PROVIDER",
            "identifier": "49363",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "QUALCHOICE PROVIDER",
            "identifier": "15666000040",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2018; 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.