NPIMap

Organization Active NPI

Ivory a. Kinslow, Mdpa

  • Ophthalmology Physician
  • El Dorado, AR
National Provider Identifier
1376986539
Registry record updated May 16, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
C7743 Issued in AR
Legal business name
IVORY A. KINSLOW, MDPA
Practice address
443 W Oak St
El Dorado, AR 71730
Phone
(870) 862-2340
Fax
(870) 863-4951
NPI assigned
Apr 8, 2013
Last updated
May 16, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 16, 2018

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

Authorized official

Name
Dr. Ivory Amelia Kinslow, MDNPI 1972575702
Title
Owner
Phone
(870) 862-2340

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2574 AR
Ophthalmology Physician 207W00000X C7743 AR Primary

Addresses

Primary practice location

443 W Oak St
El Dorado, AR 71730

Mailing address

PO Box 11090
El Dorado, AR 71730-0031
Phone (870) 862-2340

Other practice location 1

220 N Pine
Magnolia, AR 71753-2905
Phone (870) 234-4444

Other practice location 2

300 Thompson Ave
El Dorado, AR 71730-4569
Phone (870) 862-2340

Other practice location 3

310 Thompson Ave
El Dorado, AR 71730-4569
Phone (870) 862-2340

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130708000549 AR Part B Supplier - Clinic/Group Practice 3678713054 Receives reassigned benefits from 6 practitioners
Practice locations: El Dorado, AR; Magnolia, AR

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

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
Ivory a Kinslow Mdpa Optical300 Thompson Ave, El Dorado, AR 71730-4569(870) 862-2340 Prosthetic Lenses: Conventional Eyeglasses|Prosthetic Lenses: Conventional Contact Lenses|Prosthetic Lenses: Prosthetics Cataract Lenses Accepts assignmentParticipating since Aug 20, 2019

National Provider Directory

National Provider Directory
Tax ID family
Ivory a Kinslow Mdpa3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

Locations

220 N Pine
Magnolia, AR 71753
Phone (870) 234-4444

Ownership & related parties

Subparts reporting this organization as parent 2

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 7

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": "1365379200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1526428800000",
    "number": "1376986539",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 11090",
            "city": "EL DORADO",
            "state": "AR",
            "postal_code": "717300031",
            "telephone_number": "870-862-2340",
            "fax_number": "870-862-2548"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "443 W OAK ST",
            "city": "EL DORADO",
            "state": "AR",
            "postal_code": "71730",
            "telephone_number": "870-862-2340",
            "fax_number": "870-863-4951"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "220 N Pine",
            "address_purpose": "LOCATION",
            "city": "Magnolia",
            "state": "AR",
            "postal_code": "717532905",
            "country_code": "US",
            "telephone_number": "870-234-4444",
            "fax_number": "870-234-0420",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "300 Thompson Ave",
            "address_purpose": "LOCATION",
            "city": "El Dorado",
            "state": "AR",
            "postal_code": "717304569",
            "country_code": "US",
            "telephone_number": "870-862-2340",
            "fax_number": "870-863-4951",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "310 Thompson Ave",
            "address_purpose": "LOCATION",
            "city": "El Dorado",
            "state": "AR",
            "postal_code": "717304569",
            "country_code": "US",
            "telephone_number": "870-862-2340",
            "fax_number": "870-862-2548",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "IVORY A. KINSLOW, MDPA",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-04-08",
        "last_updated": "2018-05-16",
        "status": "A",
        "authorized_official_last_name": "KINSLOW",
        "authorized_official_first_name": "IVORY",
        "authorized_official_middle_name": "AMELIA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "870-862-2340",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "AR",
            "license": "2574",
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "AR",
            "license": "C7743",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in El Dorado, AR

Sources for this page

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