Individual provider Active NPI

Julie Taylor Caldwell, OD

  • Optometrist
  • West Memphis, AR
National Provider Identifier
1417067067
Registry record updated Dec 1, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2447 Issued in AR
Practice address
201 S Avalon St
West Memphis, AR 72301-4172
Phone
(870) 732-4701
Fax
(870) 732-5400
NPI assigned
Aug 30, 2006
Last updated
Dec 1, 2009By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2447 AR Primary

Addresses

Primary practice location

201 S Avalon St
West Memphis, AR 72301-4172

Mailing address

201 S Avalon St
West Memphis, AR 72301-4172
Phone (870) 732-4701

Other identifiers 2

IdentifierTypeStateIssuer
161049722MedicaidAR
176805722MedicaidAR

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
I20070810000569 AR Practitioner - Optometry 3971694548 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern College of Optometry, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

201 S Avalon
West Memphis, AR 72301-4172
Phone (870) 732-4701

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery35

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2447ARMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Dr Julie T Caldwell OD PA Optometrist CurrentSince Mar 1, 2009 Accepting new patients
Lan F Burch Optometrist Past Accepting new patients

Locations

201 S Avalon St
West Memphis, AR 72301
Phone (870) 732-4701

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1259625600000",
    "number": "1417067067",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 S AVALON ST",
            "city": "WEST MEMPHIS",
            "state": "AR",
            "postal_code": "723014172",
            "telephone_number": "870-732-4701",
            "fax_number": "870-732-5400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 S AVALON ST",
            "city": "WEST MEMPHIS",
            "state": "AR",
            "postal_code": "723014172",
            "telephone_number": "870-732-4701",
            "fax_number": "870-732-5400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CALDWELL",
        "first_name": "JULIE",
        "middle_name": "TAYLOR",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-30",
        "last_updated": "2009-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "AR",
            "license": "2447",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "161049722",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "176805722",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in West Memphis, AR

Sources for this page

Verify at the official NPI Registry.