Active NPI
Paul K. Anthony, O.D.
- Low Vision Rehabilitation Optometrist
- Springfield, IL
National Provider Identifier
1356360788
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Low Vision Rehabilitation Optometrist
- Practice address
- 121 N Grand Ave W
Springfield, IL 62702-2562 - Phone
- (217) 528-3233
- Fax
- (217) 528-4511
- NPI assigned
- Jul 18, 2006
- Last updated
- Jul 8, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Low Vision Rehabilitation Optometrist | 152WL0500X | IL | Primary |
Addresses
Primary practice location
121 N Grand Ave W
Springfield, IL 62702-2562
Mailing address
3 Ottowood Dr
Springfield, IL 62711-7912
Phone (217) 528-3233
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
| License | State | Type | Specialty |
|---|---|---|---|
| 046007078 | IL | MD | Low Vision Rehabilitation Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Tazewell County Resource Centers Inc | Low Vision Rehabilitation | Past | Accepting new patients |
| Springfield Clinic, LLP | Past | Accepting new patients | |
| Springfield Vision Care Associates, LTD | Low Vision Rehabilitation | Past | Accepting new patients |
Organizations & group practices 3
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Multi-Specialty Clinic/Center
- Springfield, IL
- NPI 1780638478
-
dba Vision Care Associates
- Optometrist
- Springfield, IL
- NPI 1811935406
Low Vision Rehabilitation
-
dba TCRC Sight Center
- Low Vision Rehabilitation Optometrist
- East Peoria, IL
- NPI 1265431506
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153180800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1356360788",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3 OTTOWOOD DR",
"city": "SPRINGFIELD",
"state": "IL",
"postal_code": "627117912",
"telephone_number": "217-528-3233",
"fax_number": "217-528-4511"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "121 N GRAND AVE W",
"city": "SPRINGFIELD",
"state": "IL",
"postal_code": "627022562",
"telephone_number": "217-528-3233",
"fax_number": "217-528-4511"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ANTHONY",
"first_name": "PAUL",
"middle_name": "K.",
"name_prefix": "Dr.",
"credential": "O.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-18",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "152WL0500X",
"taxonomy_group": "",
"desc": "Optometrist, Low Vision Rehabilitation",
"state": "IL",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Springfield, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.