Mary Agnes Bigelow, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

Practice address

106 E Main St
Beardstown, IL 62618-1241

Phone

(217) 323-1146

Fax

(217) 323-1156

NPI assigned

Sep 26, 2005

Last updated

Sep 6, 2007By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Prairie Eye Center LTD

  • Optometrist
  • Beardstown, IL
  • NPI 1376773598
  NPD (past)

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

{
    "created_epoch": "1127692800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1189036800000",
    "number": "1457347346",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2020 W ILES AVE",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627044174",
            "telephone_number": "217-698-3030",
            "fax_number": "217-698-4728"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "106 E MAIN ST",
            "city": "BEARDSTOWN",
            "state": "IL",
            "postal_code": "626181241",
            "telephone_number": "217-323-1146",
            "fax_number": "217-323-1156"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BIGELOW",
        "first_name": "MARY",
        "middle_name": "AGNES",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-09-26",
        "last_updated": "2007-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MO",
            "license": "T02559",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00390109",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Beardstown Supportive Living LLC
• Beardstown Therapy Clinic
• Laurie Jean Beavers, FAMILY NURSE PRACTIT
• Amanda J Bechard, MHP
• Kembra Bell, MHP
• Tierney Birdsell, MHP
• Beth M Blankenship, PTA/L
• Tanya Boyd
• Tobi Brackett, BS
• Bridgeview Housing Corporation

• Optometrist in Beardstown, IL
• Providers in Beardstown, IL by specialty
• Optometrist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.