Prairie Eye Center LTD

Primary specialty

OptometristTaxonomy code 152W00000X

License

042000760 Issued in IL

Legal business name

PRAIRIE EYE CENTER LTD

Practice address

106 E Main St
Beardstown, IL 62618-1241

Phone

(217) 323-1146

Fax

(217) 323-1145

NPI assigned

Jul 22, 2009

Organization subpart

Yes

Parent organization

PRAIRIE EYE CENTER LTDAs reported in NPPES

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

Authorized official

Name

Jason Lang

Title

Billing Administrator

Phone

(217) 698-3030

Specialties & licenses 2

Addresses

Part of

Eye Care Prof of Hillsb

Locations

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• Prairie Eye Center, LTD

  • Ophthalmology Physician
  • Springfield, IL
  • NPI 1447222864
  NPPES parent name

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Mary Agnes Bigelow, O.D.

  • Optometrist
  • Beardstown, IL
  • NPI 1457347346
  NPD (past)
• Stephanie R Goggin, OD

  • Optometrist
  • Edwardsville, IL
  • NPI 1013965367
  NPD (past)
• Sara Marie Siebert, OD

  • Optometrist
  • Quincy, IL
  • NPI 1841778115
  NPD (past)
• Erica Danielle Bennehoff, O.D.

  • Optometrist
  • Hanover, MD
  • NPI 1346228665
  NPD (past)

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

{
    "created_epoch": "1248220800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1613520000000",
    "number": "1376773598",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "106 E MAIN ST",
            "city": "BEARDSTOWN",
            "state": "IL",
            "postal_code": "626181241",
            "telephone_number": "217-323-1146",
            "fax_number": "217-323-1145"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "106 E MAIN ST",
            "city": "BEARDSTOWN",
            "state": "IL",
            "postal_code": "626181241",
            "telephone_number": "217-323-1146",
            "fax_number": "217-323-1145"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRAIRIE EYE CENTER LTD",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PRAIRIE EYE CENTER LTD",
        "enumeration_date": "2009-07-22",
        "last_updated": "2021-02-17",
        "certification_date": "2021-02-17",
        "status": "A",
        "authorized_official_last_name": "LANG",
        "authorized_official_first_name": "JASON",
        "authorized_official_title_or_position": "BILLING ADMINISTRATOR",
        "authorized_official_telephone_number": "217-698-3030"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": "IL",
            "license": "042000760",
            "primary": true
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nicholas Neeley, PHARMD
• Chris Alva Ottwell
• Pamida Stores Operating Co LLC
• Parkview Housing Corporation
• Doris Sue Pilger
• Karen S Provart, MA,LPC
• Billie Jo Quincy
• Daisy Reyes Renteria, RSA
• Sarah Roegge, FNP
• Susan Rolf, MA QMHP

• Optometrist in Beardstown, IL
• Providers in Beardstown, IL by specialty
• Optometrist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2021; 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.