Organization Active NPI

Hurst Eye Care Center, PA.

  • Optometrist
  • Bentonville, AR
National Provider Identifier
1457577256
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2448 Issued in AR
Legal business name
HURST EYE CARE CENTER, PA.
Practice address
1412 SE 14TH St
Bentonville, AR 72712-6812
Phone
(479) 271-9700
Fax
(479) 271-9771
NPI assigned
Apr 18, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Ms. Toni Diane McCullough
Title
Benefits Coordinator
Phone
(479) 271-9700

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 2448 AR Primary

Addresses

Primary practice location

1412 SE 14TH St
Bentonville, AR 72712-6812

Mailing address

1412 SE 14TH St
Bentonville, AR 72712-6812
Phone (479) 271-9700

Other names 1

  • ROBERT K. HURST Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120525000356 AR Part B Supplier - Clinic/Group Practice 7214190479 Receives reassigned benefits from 1 practitioner
Practice locations: Bentonville, AR

National Provider Directory

National Provider Directory

Locations

1412 SE 14th St
Bentonville, AR 72712
Phone (479) 271-9700

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1176854400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1457577256",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1412 SE 14TH ST",
            "city": "BENTONVILLE",
            "state": "AR",
            "postal_code": "727126812",
            "telephone_number": "479-271-9700",
            "fax_number": "479-271-9771"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1412 SE 14TH ST",
            "city": "BENTONVILLE",
            "state": "AR",
            "postal_code": "727126812",
            "telephone_number": "479-271-9700",
            "fax_number": "479-271-9771"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HURST EYE CARE CENTER, PA.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-18",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MCCULLOUGH",
        "authorized_official_first_name": "TONI",
        "authorized_official_middle_name": "DIANE",
        "authorized_official_title_or_position": "BENEFITS COORDINATOR",
        "authorized_official_telephone_number": "479-271-9700",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "AR",
            "license": "2448",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ROBERT K. HURST",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Bentonville, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.