NPIMap

Organization Active NPI

Bibb County Eye Care

  • Optometrist
  • Centreville, AL
National Provider Identifier
1548434657
Registry record updated Sep 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
BIBB COUNTY EYE CARE
Practice address
223 Pierson Ave
Centreville, AL 35042-2919
Phone
(205) 926-4816
Fax
(888) 803-4916
NPI assigned
Apr 18, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2024

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

Authorized official

Name
Tracy Griffin
Title
Office Manager
Phone
(205) 926-4816

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X Primary
Eyewear Supplier 332H00000X S-374-TA-005 AL

Addresses

Primary practice location

223 Pierson Ave
Centreville, AL 35042-2919

Mailing address

223 Pierson Ave
Centreville, AL 35042-2919
Phone (205) 926-4816

Other identifiers 3

IdentifierTypeStateIssuer
000059437MedicaidAL
S-374-TA-005OtherALAL LICENSE
406183603OtherALRRTRAV

Other names 1

  • Charles D Allgood Former legal business name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250515000214 AL Part B Supplier - Clinic/Group Practice 7012034226 Receives reassigned benefits from 2 practitioners
Practice locations: Centreville, AL

National Provider Directory

National Provider Directory

Locations

223 Pierson Ave
Ste 2332
Centreville, AL 35042
Phone (205) 926-4816

223 Pierson Ave
Centreville, AL 35042
Phone (205) 926-4404

Practitioners & affiliated clinicians

Practitioners 2

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": "1208476800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1726617600000",
    "number": "1548434657",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "223 PIERSON AVE",
            "city": "CENTREVILLE",
            "state": "AL",
            "postal_code": "350422919",
            "telephone_number": "205-926-4816",
            "fax_number": "888-803-4916"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "223 PIERSON AVE",
            "city": "CENTREVILLE",
            "state": "AL",
            "postal_code": "350422919",
            "telephone_number": "205-926-4816",
            "fax_number": "888-803-4916"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BIBB COUNTY EYE CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-18",
        "last_updated": "2024-09-18",
        "certification_date": "2024-09-18",
        "status": "A",
        "authorized_official_last_name": "GRIFFIN",
        "authorized_official_first_name": "TRACY",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "205-926-4816"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": "AL",
            "license": "S-374-TA-005",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000059437",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AL LICENSE",
            "identifier": "S-374-TA-005",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RRTRAV",
            "identifier": "406183603",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Charles D Allgood",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Centreville, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2024; 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.