NPIMap

Organization Active NPI

Four Corners Eye Clinic, PC

  • Specialist
  • Pagosa Springs, CO
National Provider Identifier
1386875441
Registry record updated Feb 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
39400 Issued in CO
Legal business name
FOUR CORNERS EYE CLINIC, PC
Practice address
190 Talisman Dr
Pagosa Springs, CO 81147-9171
Phone
(970) 259-2202
Fax
(970) 259-2837
NPI assigned
Aug 6, 2009
Organization subpart
Yes
Parent organization
FOUR CORNERS EYE CLINIC, PCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 3, 2024

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

Authorized official

Name
Dr. Eric C Meyer, MDNPI 1003989633
Title
Owner
Phone
(970) 259-2202

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
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X 39400 CO Primary

Addresses

Primary practice location

190 Talisman Dr
Pagosa Springs, CO 81147-9171

Mailing address

575 Rivergate Lane
Suite 212
Durango, CO 81301
Phone (970) 259-2202

Other names 1

  • Four Corners Eye Clinic Pagosa Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040329000385 CO Part B Supplier - Clinic/Group Practice 1658263173 Receives reassigned benefits from 6 practitioners
2 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Cortez, CO; Durango, CO; Pagosa Springs, CO

Other NPIs on the same Medicare enrollment 2

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

National Provider Directory

National Provider Directory
Tax ID family
John M Parkinson MD3 organizations share this tax ID, including this one
Part of
John M Parkinson MD

Other organizations with this tax ID 2

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

Locations

190 Talisman Dr
Pagosa Springs, CO 81147
Phone (970) 259-2202

Ownership & related parties

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.

Practitioners & affiliated clinicians

Practitioners 6

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

NPI Registry JSON

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

{
    "created_epoch": "1249516800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1706918400000",
    "number": "1386875441",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "575 RIVERGATE LANE",
            "address_2": "SUITE 212",
            "city": "DURANGO",
            "state": "CO",
            "postal_code": "81301",
            "telephone_number": "970-259-2202",
            "fax_number": "970-259-2837"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "190 TALISMAN DR",
            "city": "PAGOSA SPRINGS",
            "state": "CO",
            "postal_code": "811479171",
            "telephone_number": "970-259-2202",
            "fax_number": "970-259-2837"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOUR CORNERS EYE CLINIC, PC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "FOUR CORNERS EYE CLINIC, PC",
        "enumeration_date": "2009-08-06",
        "last_updated": "2024-02-03",
        "certification_date": "2024-02-03",
        "status": "A",
        "authorized_official_last_name": "MEYER",
        "authorized_official_first_name": "ERIC",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "970-259-2202",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "CO",
            "license": "39400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Four Corners Eye Clinic Pagosa",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Pagosa Springs, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2024; 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.