Individual provider Active NPI

Kylie Hilliard, O.D.

  • Optometrist
  • Paragould, AR
National Provider Identifier
1396978029
Registry record updated Dec 9, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2556 Issued in AR
Practice address
2802 W Kingshighway
Paragould, AR 72450-2617
Phone
(870) 236-7800
NPI assigned
Aug 28, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 9, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2556 AR Primary

Addresses

Primary practice location

2802 W Kingshighway
Paragould, AR 72450-2617

Mailing address

2802 W Kingshighway
Paragould, AR 72450-2617
Phone (870) 243-1253

Other identifiers 1

IdentifierTypeStateIssuer
203674722MedicaidAR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140313000501 AR Practitioner - Optometry 0244460285 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern College of Optometry, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southern Eye Associates LTDGroup PAC ID 4688576739, 8 clinicians

Practice addresses (Care Compare)

601 E Matthews Ave
Jonesboro, AR 72401-3145
Phone (870) 935-6396

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2556ARMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Southern Eye Associates LTD Optometrist CurrentSince Mar 1, 2021 Accepting new patients
Southern Eye Associates LTD Optometrist CurrentSince Mar 1, 2021 Accepting new patients
Jonathan B. Ross OD PA Optometrist CurrentSince Aug 9, 2014 Accepting new patients

Locations

1815 E Highland Dr
Jonesboro, AR 72401
Phone (870) 931-2020

601 E Matthews Ave
Jonesboro, AR 72401
Phone (870) 935-6396

2802 W Kingshighway
Paragould, AR 72450
Phone (870) 236-7785

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1251417600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1575849600000",
    "number": "1396978029",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2802 W KINGSHIGHWAY",
            "city": "PARAGOULD",
            "state": "AR",
            "postal_code": "724502617",
            "telephone_number": "870-243-1253"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2802 W KINGSHIGHWAY",
            "city": "PARAGOULD",
            "state": "AR",
            "postal_code": "724502617",
            "telephone_number": "870-236-7800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HILLIARD",
        "first_name": "KYLIE",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-08-28",
        "last_updated": "2019-12-09",
        "certification_date": "2019-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "AR",
            "license": "2556",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "203674722",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Paragould, AR

Sources for this page

Verify at the official NPI Registry.