Individual provider Active NPI

Casey Royce Dillard, O.D.

  • Optometrist
  • Fort Smith, AR
National Provider Identifier
1487033759
Registry record updated Jul 6, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2718 Issued in AR
Practice address
4189 Phoenix Ave
Fort Smith, AR 72903-6013
Phone
(479) 434-4668
NPI assigned
May 20, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 6, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2718 AR Primary

Addresses

Primary practice location

4189 Phoenix Ave
Fort Smith, AR 72903-6013

Mailing address

467460 E 1070 Rd
Sallisaw, OK 74955-7116
Phone (918) 208-7257

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Dang Eyecare & Associates, P.a. Optometrist CurrentSince Jun 26, 2015 Accepting new patients

Locations

4189 Phoenix Ave
Ste B
Fort Smith, AR 72903
Phone (479) 434-4668

4189 Phoenix Ave
Fort Smith, AR 72903
Phone (479) 434-3680

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1432080000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1436140800000",
    "number": "1487033759",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "467460 E 1070 RD",
            "city": "SALLISAW",
            "state": "OK",
            "postal_code": "749557116",
            "telephone_number": "918-208-7257"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4189 PHOENIX AVE",
            "city": "FORT SMITH",
            "state": "AR",
            "postal_code": "729036013",
            "telephone_number": "479-434-4668"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DILLARD",
        "first_name": "CASEY",
        "middle_name": "ROYCE",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-05-20",
        "last_updated": "2015-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "AR",
            "license": "2718",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Smith, AR

Sources for this page

Verify at the official NPI Registry.