Active NPI
Carrie L. Hartigan, OD
- Optometrist
- Springfield, MO
National Provider Identifier
1528409158
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 2013020890
- Practice address
- 1229 E Seminole St
4TH FL
Springfield, MO 65804-2227 - Phone
- (417) 820-9393
- Fax
- (417) 820-9725
- NPI assigned
- Jul 11, 2013
- Last updated
- Nov 20, 2013
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 2013020890 | MO | Primary |
Addresses
Primary practice location
1229 E Seminole St
4TH FL
Springfield, MO 65804-2227
Mailing address
PO Box 2580
Springfield, MO 65801-2580
Phone (417) 829-4620
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1528409158 | Medicaid | MO | |
| 199216722 | Medicaid | AR | |
| P01222591 | Other | MO | RR MCR |
| 431560263 | Other | MO | TRICARE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in KS
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Optometry
- Education
- University of Missouri St Louis - School of Optometry, 2013
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
18208 W 119TH St
Olathe, KS 66061-9507
Phone (913) 261-8327
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Cataract surgery | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2013020890 | MO | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ridgeview Eye Care LLC | Optometrist | Current | Accepting new patients |
| Ad Astra Eye, LLC | Past | Accepting new patients |
Locations
33321 Lexington Ave
De Soto, KS 66018
Phone (913) 583-1991
18208 W 119th St
Olathe, KS 66061
Phone (913) 261-8327
Interoperability endpoints
- chartigan351805@directb.mercy.net
Organizations & group practices 2
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.
-
- Optometrist
- Olathe, KS
- NPI 1053599522
-
- Ophthalmology Physician
- Lawrence, KS
- NPI 1770016727
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1373500800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1384905600000",
"number": "1528409158",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 2580",
"city": "SPRINGFIELD",
"state": "MO",
"postal_code": "658012580",
"telephone_number": "417-829-4620"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1229 E SEMINOLE ST",
"address_2": "4TH FL",
"city": "SPRINGFIELD",
"state": "MO",
"postal_code": "658042227",
"telephone_number": "417-820-9393",
"fax_number": "417-820-9725"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HARTIGAN",
"first_name": "CARRIE",
"middle_name": "L.",
"credential": "OD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-07-11",
"last_updated": "2013-11-20",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "MO",
"license": "2013020890",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1528409158",
"state": "MO"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "199216722",
"state": "AR"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RR MCR",
"identifier": "P01222591",
"state": "MO"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TRICARE",
"identifier": "431560263",
"state": "MO"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Springfield, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.