Iiii Optical - Spa City LLC

Primary specialty

Eyewear SupplierTaxonomy code 332H00000X

Legal business name

IIII OPTICAL - SPA CITY LLC

Practice address

3604 Central Ave Ste a
Hot Springs, AR 71913-6458

Phone

(501) 318-1111

Fax

(501) 318-1119

NPI assigned

Mar 16, 2021

Last updated

Mar 16, 2021By 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

Amy Offutt

Title

Controller

Phone

(870) 536-4100

Specialties & licenses 1

Addresses

Practitioners 1

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.

• Donald Gauldin Jr., MD

  • Ophthalmology Physician
  • Little Rock, AR
  • NPI 1871912204
  NPD (past)

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

{
    "created_epoch": "1615852800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1615852800000",
    "number": "1386229870",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3805 W 28TH AVE",
            "city": "PINE BLUFF",
            "state": "AR",
            "postal_code": "716034774",
            "telephone_number": "870-536-4100",
            "fax_number": "870-534-3982"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3604 CENTRAL AVE STE A",
            "city": "HOT SPRINGS",
            "state": "AR",
            "postal_code": "719136458",
            "telephone_number": "501-318-1111",
            "fax_number": "501-318-1119"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IIII OPTICAL - SPA CITY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-03-16",
        "last_updated": "2021-03-16",
        "certification_date": "2021-03-16",
        "status": "A",
        "authorized_official_last_name": "OFFUTT",
        "authorized_official_first_name": "AMY",
        "authorized_official_title_or_position": "CONTROLLER",
        "authorized_official_telephone_number": "870-536-4100"
    },
    "taxonomies": [
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Zachary Wayne Husband, DO
• Matthew Jarett Huskey, APRN FNP-C
• James Michael Hyatt, RN
• Oyidie Igbokidi, MD
• Ihc Supply Incorporated
• Impact Health and Wellness PLLC
• Independence Healthcare Inc
• Infuserx, LLC (InfuseRx 10)
• Chuck Ingalls
• Christa Ingram, COTA

• Eyewear Supplier in Hot Springs, AR
• Providers in Hot Springs, AR by specialty
• Eyewear Supplier in Arkansas

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