NPIMap

Organization Active NPI

Gailey Eye Clinic, LTD

  • Ophthalmic Technician/Technologist
  • Peru, IL
National Provider Identifier
1487859401
Registry record updated Apr 14, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmic Technician/TechnologistTaxonomy code 156FX1100X
Legal business name
GAILEY EYE CLINIC, LTD
Practice address
2121 Marquette Rd
Peru, IL 61354-1588
Phone
(815) 224-1100
NPI assigned
Jun 19, 2007
Last updated
Apr 14, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 14, 2008

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

Authorized official

Name
Rebecca Cox
Title
Administrative Assistant
Phone
(309) 829-5311

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmic Technician/TechnologistGroup: 193400000X SINGLE SPECIALTY GROUP 156FX1100X IL Primary

Addresses

Primary practice location

2121 Marquette Rd
Peru, IL 61354-1588

Mailing address

2121 Marquette Rd
Peru, IL 61354-1588
Phone (815) 224-1100

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040802000570 IL Part B Supplier - Clinic/Group Practice 2769469337 Receives reassigned benefits from 23 practitioners
5 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Peoria, IL; Watseka, IL; Springfield, IL; Peru, IL; Pekin, IL; Ottawa, IL; Galesburg, IL; Forsyth, IL…

Other NPIs on the same Medicare enrollment 5

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Invalid Entry5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 3

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": "1182211200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208131200000",
    "number": "1487859401",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2121 MARQUETTE RD",
            "city": "PERU",
            "state": "IL",
            "postal_code": "613541588",
            "telephone_number": "815-224-1100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2121 MARQUETTE RD",
            "city": "PERU",
            "state": "IL",
            "postal_code": "613541588",
            "telephone_number": "815-224-1100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GAILEY EYE CLINIC, LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-19",
        "last_updated": "2008-04-14",
        "status": "A",
        "authorized_official_last_name": "COX",
        "authorized_official_first_name": "REBECCA",
        "authorized_official_title_or_position": "ADMINISTRATIVE ASSISTANT",
        "authorized_official_telephone_number": "309-829-5311"
    },
    "taxonomies": [
        {
            "code": "156FX1100X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Technician/Technologist, Ophthalmic",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Peru, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2008; 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.