Organization Active NPI

20 20 Eye World of Greenville LLC

  • Optometrist
  • Greenville, MS
National Provider Identifier
1376374371
Registry record updated Aug 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
20 20 EYE WORLD OF GREENVILLE LLC
Practice address
1607 Highway 1 S
Greenville, MS 38701-7832
Phone
(662) 378-2085
NPI assigned
Aug 12, 2024
Last updated
Aug 12, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2024

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

Authorized official

Name
Dr. Collin Quinn Rounsavall, ODNPI 1326877457
Title
Optometrist/Owner
Phone
(662) 822-8181

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
Optometrist 152W00000X NU Primary

Addresses

Primary practice location

1607 Highway 1 S
Greenville, MS 38701-7832

Mailing address

1607 Highway 1 S
Greenville, MS 38701-7832
Phone (662) 378-2085

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20241127002619 MS Part B Supplier - Clinic/Group Practice 3779018759 Receives reassigned benefits from 2 practitioners
Practice locations: Greenville, MS
O20250502000750 MS DME Supplier - Physician - Optometrist 3779018759 Practice locations: Greenville, MS

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
20 20 Eye World of Greenville LLC1607 Highway 1 S, Greenville, MS 38701-7832(662) 378-2085 Prosthetic Lenses: Conventional Eyeglasses|Prosthetic Lenses: Conventional Contact Lenses|Prosthetic Lenses: Prosthetics Cataract Lenses Accepts assignmentParticipating since Dec 1, 2024

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

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": "1723420800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1723420800000",
    "number": "1376374371",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1607 HIGHWAY 1 S",
            "city": "GREENVILLE",
            "state": "MS",
            "postal_code": "387017832",
            "telephone_number": "662-378-2085"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1607 HIGHWAY 1 S",
            "city": "GREENVILLE",
            "state": "MS",
            "postal_code": "387017832",
            "telephone_number": "662-378-2085"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "20 20 EYE WORLD OF GREENVILLE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-08-12",
        "last_updated": "2024-08-12",
        "certification_date": "2024-08-12",
        "status": "A",
        "authorized_official_last_name": "ROUNSAVALL",
        "authorized_official_first_name": "COLLIN",
        "authorized_official_middle_name": "QUINN",
        "authorized_official_title_or_position": "OPTOMETRIST/OWNER",
        "authorized_official_telephone_number": "662-822-8181",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenville, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.