Vision Care Center of Northeast Arkansas LLC

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

Legal business name

VISION CARE CENTER OF NORTHEAST ARKANSAS LLC

Practice address

623 E Matthews Ave
Jonesboro, AR 72401-3145

Phone

(870) 932-2211

Fax

(870) 972-5152

NPI assigned

Jun 30, 2006

Organization subpart

No

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

Authorized official

Name

Michelle Bacot

Title

Administrator

Phone

(870) 932-2211

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in AR2 enrollments

Enrollment records 2

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

Locations

Interoperability endpoints

• Direct secure messaging: winboden@vccna.intellechartdirect.net
• Direct secure messaging: cpatterson@vccna.intellechartdirect.net

Practitioners 10

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

• Brandon Corey Craine, OD

  • Optometrist
  • Manila, AR
  • NPI 1285663583
  Medicare reassignment Care Compare group NPD
• William Eric Futrell, OD

  • Optometrist
  • Pocahontas, AR
  • NPI 1093747735
  Medicare reassignment Care Compare group NPD
• Russell Lee Harral III, MD

  • Ophthalmology Physician
  • Jonesboro, AR
  • NPI 1215968425
  Medicare reassignment Care Compare group NPD
• William Zachery Inboden, OD

  • Optometrist
  • Jonesboro, AR
  • NPI 1235655051
  Medicare reassignment Care Compare group NPD
• Cody Patterson, O.D.

  • Optometrist
  • Jonesboro, AR
  • NPI 1417330101
  Medicare reassignment Care Compare group NPD
• Alyssa Nicole Wenger, MD

  • Ophthalmology Physician
  • Jonesboro, AR
  • NPI 1992733562
  Medicare reassignment Care Compare group NPD
• Jerry Tuck Young, OD

  • Optometrist
  • Jonesboro, AR
  • NPI 1104857333
  Medicare reassignment Care Compare group NPD
• Brandon Douglas Rouse, OD

  • Optometrist
  • Kennett, MO
  • NPI 1023122017

  AR

  Medicare reassignment Care Compare group NPD
• Daniel Baltz, OD

  • Optometrist
  • Pocahontas, AR
  • NPI 1215962295
  Medicare reassignment NPD
• Thomas L Nix, MD

  • Ophthalmology Physician
  • Jonesboro, AR
  • NPI 1417098153
  Medicare reassignment NPD

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

{
    "created_epoch": "1151625600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1727222400000",
    "number": "1447288097",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "623 E MATTHEWS AVE",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "724013145",
            "telephone_number": "870-932-2211",
            "fax_number": "870-972-5152"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "623 E MATTHEWS AVE",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "724013145",
            "telephone_number": "870-932-2211",
            "fax_number": "870-972-5152"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VISION CARE CENTER OF NORTHEAST ARKANSAS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-30",
        "last_updated": "2024-09-25",
        "certification_date": "2024-09-25",
        "status": "A",
        "authorized_official_last_name": "BACOT",
        "authorized_official_first_name": "MICHELLE",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "870-932-2211"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Ophthalmology",
            "state": "AR",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "142619002",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "142990722",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ammi Vinson
• Kelsey Vinson, DO
• Kristie Vinson, PT
• Sara Virgin
• Harsha Vishnu Savithri
• Vision Therapy Center of Jonesboro, P.L.L.C.
• Visionary Eye Care, PA
• Vital Movement, LLC
• Vitality Chiropractic
• Vitruvian Dietary Solutions, PLLC

• Ophthalmology Physician in Jonesboro, AR
• Providers in Jonesboro, AR by specialty
• Ophthalmology Physician in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2024; 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.