Organization Active NPI

Dr Julie T Caldwell OD PA

  • Optometrist
  • West Memphis, AR
National Provider Identifier
1447489612
Registry record updated Dec 1, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2447 Issued in AR
Legal business name
DR JULIE T CALDWELL OD PA
Practice address
201 S Avalon St
West Memphis, AR 72301-4172
Phone
(870) 732-4701
Fax
(870) 732-5400
NPI assigned
Jul 9, 2009
Last updated
Dec 1, 2009By the provider in NPPES
Organization subpart
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

Authorized official

Name
Dr. Julie Taylor Caldwell, ODNPI 1417067067
Title
President
Phone
(870) 732-4701

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 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

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090713000691 AR Part B Supplier - Clinic/Group Practice 2365594900 Receives reassigned benefits from 1 practitioner
Practice locations: West Memphis, AR

National Provider Directory

National Provider Directory

Locations

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

Practitioners & affiliated clinicians

Practitioners 2

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": "1247097600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1259625600000",
    "number": "1447489612",
    "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": {
        "organization_name": "DR JULIE T CALDWELL OD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-07-09",
        "last_updated": "2009-12-01",
        "status": "A",
        "authorized_official_last_name": "CALDWELL",
        "authorized_official_first_name": "JULIE",
        "authorized_official_middle_name": "TAYLOR",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "870-732-4701",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "AR",
            "license": "2447",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Memphis, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2009; 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.