Organization Active NPI

Specialty Eyecare of Evansville, LLC

  • Ophthalmology Physician
  • Evansville, IN
National Provider Identifier
1407195449
Registry record updated Feb 12, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
Legal business name
SPECIALTY EYECARE OF EVANSVILLE, LLC
Practice address
954 S Kenmore Dr
Evansville, IN 47714-7513
Phone
(812) 402-2020
NPI assigned
Feb 12, 2013
Last updated
Feb 12, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 12, 2013

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

Authorized official

Name
Dr. William G Carey, MDNPI 1104821966
Title
Partner
Phone
(812) 402-2020

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
OptometristGroup: 193200000X MULTI-SPECIALTY GROUP 152W00000X
Ophthalmology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207W00000X Primary

Addresses

Primary practice location

954 S Kenmore Dr
Evansville, IN 47714-7513

Mailing address

PO Box 3597
Evansville, IN 47734-3597
Phone (812) 402-2020

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130608000194 IN Part B Supplier - Clinic/Group Practice 7517105208 Receives reassigned benefits from 2 practitioners
Practice locations: Evansville, IN

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.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
15D2084702Specialty Eyecare of Evansville954 S Kenmore Dr, Evansville, IN 47714Certificate of waiverSep 28, 2026

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 4

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": "1360627200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1360627200000",
    "number": "1407195449",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3597",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477343597",
            "telephone_number": "812-402-2020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "954 S KENMORE DR",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477147513",
            "telephone_number": "812-402-2020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPECIALTY EYECARE OF EVANSVILLE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-02-12",
        "last_updated": "2013-02-12",
        "status": "A",
        "authorized_official_last_name": "CAREY",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "812-402-2020",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Evansville, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2013; 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.