Mississippi Eye Care Associates of Jackson, PLLC

Primary specialty

OptometristTaxonomy code 152W00000X

License

783 Issued in MS

Legal business name

MISSISSIPPI EYE CARE ASSOCIATES OF JACKSON, PLLC

Practice address

310 West Woodrow Wilson Avenue
Suite 300
Jackson, MS 39213-7662

Phone

(601) 366-9020

Fax

(601) 321-3979

NPI assigned

Nov 26, 2008

Last updated

Dec 8, 2016By 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

Dr. Christopher Terrell Bullin, O.D.NPI 1457541450

Title

Owner

Phone

(601) 366-9020

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MS

Enrollment records 1

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Mississippi Eyecare Associates of Byram, PLLC.

  • Optometrist
  • Byram, MS
  • NPI 1427433200

  O20090324000450

  Same enrollment

Tax ID family

Mississippi Eye Care Associates of Jackson PLLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Mississippi Eyecare Associates of Jackson, PLLC.

  • Optometrist
  • Jackson, MS
  • NPI 1730637521
  NPD tax ID

Locations

Practitioners 3

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.

• Christopher Bullin, O.D.

  • Optometrist
  • Jackson, MS
  • NPI 1457541450
  Medicare reassignment Care Compare group NPD Authorized official
• Sherrall Lecella Jenkins, OD

  • Optometrist
  • Fort Worth, TX
  • NPI 1225849268

  MS

  Medicare reassignment Care Compare group NPD
• Chesley Kelly Bullin

  • Registered Nurse
  • Brandon, MS
  • NPI 1083573885
  NPD

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

{
    "created_epoch": "1227657600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1481155200000",
    "number": "1366697799",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "310 WEST WOODROW WILSON DRIVE",
            "address_2": "SUITE 300",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392137662",
            "telephone_number": "601-366-9020",
            "fax_number": "601-321-3979"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "310 WEST WOODROW WILSON AVENUE",
            "address_2": "SUITE 300",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392137662",
            "telephone_number": "601-366-9020",
            "fax_number": "601-321-3979"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MISSISSIPPI EYE CARE ASSOCIATES OF JACKSON, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-11-26",
        "last_updated": "2016-12-08",
        "status": "A",
        "authorized_official_last_name": "BULLIN",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_middle_name": "TERRELL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "601-366-9020",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": "MS",
            "license": "783",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MS",
            "license": "783",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mississippi Department of Rehabilitaion SVS
• Mississippi Ear, Nose and Throat Surgical Associates
• Mississippi Em-I Medical Services
• Mississippi Em-I Medical Services PC
• Mississippi Emergency Physician Services, LLC
• Mississippi Eyecare Associates of Jackson, PLLC.
• Mississippi Families for Kids
• Mississippi Foot and Surgical Center, LLC (Bryan T Sullivan)
• Mississippi Foot Clinic, Inc
• Mississippi Health Services, LLC

• Optometrist in Jackson, MS
• Providers in Jackson, MS by specialty
• Optometrist in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2016; 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.