Eagle Mountain Eye Care

Primary specialty

OptometristTaxonomy code 152W00000X

License

2657 Issued in AR

Legal business name

EAGLE MOUNTAIN EYE CARE

Practice address

3150 Harrison St
Batesville, AR 72501-7515

Phone

(870) 793-6544

Fax

(870) 793-7024

NPI assigned

Jun 20, 2012

Organization subpart

No

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

Authorized official

Name

Dr. Dustin Vance, O.D.NPI 1235445297

Title

President

Phone

(573) 382-2974

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in AR

Enrollment records 1

Locations

Practitioners 3

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

• Dustin Vance, O.D.

  • Optometrist
  • Batesville, AR
  • NPI 1235445297
  Medicare reassignment Care Compare group NPD Authorized official
• Blaine Carson, O.D.

  • Optometrist
  • Jonesboro, AR
  • NPI 1275168213
  Medicare reassignment Care Compare group NPD
• Jacob Paul Moll, O.D.

  • Optometrist
  • Jonesboro, AR
  • NPI 1942493234
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1340150400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1340150400000",
    "number": "1407119985",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3150 HARRISON ST",
            "city": "BATESVILLE",
            "state": "AR",
            "postal_code": "725017515",
            "telephone_number": "870-793-6544",
            "fax_number": "870-793-7024"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3150 HARRISON ST",
            "city": "BATESVILLE",
            "state": "AR",
            "postal_code": "725017515",
            "telephone_number": "870-793-6544",
            "fax_number": "870-793-7024"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAGLE MOUNTAIN EYE CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-06-20",
        "last_updated": "2012-06-20",
        "status": "A",
        "authorized_official_last_name": "VANCE",
        "authorized_official_first_name": "DUSTIN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "573-382-2974",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "AR",
            "license": "2657",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "187164722",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• April Dunn
• Brenda Talley Dunn, R.D.,L.D
• George M Dunn, CRNA
• Donna Dutton, CNP
• E.J. Jones, MD, P.a.
• Alan Eckler
• Econo-Mart Pharmacy
• Econo-Mart Pharmacy Inc
• Econo-Mart Pharmacy Inc
• Luke Edgecombe, M.D.

• Optometrist in Batesville, AR
• Providers in Batesville, AR by specialty
• Optometrist in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2012; 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.