Active NPI
Angela Eagle, OD
- Optometrist
- Siloam Springs, AR
National Provider Identifier
1548699317
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 2692
- Practice address
- 2901 Highway 412 E
Siloam Springs, AR 72761-8673 - Phone
- (479) 238-0257
- NPI assigned
- Nov 2, 2013
- Last updated
- Aug 12, 2014
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 2013040188 | MO | |
| Optometrist | 152W00000X | 2692 | AR | Primary |
Addresses
Primary practice location
2901 Highway 412 E
Siloam Springs, AR 72761-8673
Mailing address
RR 3 Box 2290
Stilwell, OK 74960-9537
Phone (918) 575-1558
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in AR
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20140620001226 | AR | Practitioner - Optometry | 5193949717 | Practice locations: Siloam Springs, AR |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2692 | AR | MD | Optometrist |
| 2013040188 | MO | MD | Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1383350400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1407801600000",
"number": "1548699317",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "RR 3 BOX 2290",
"city": "STILWELL",
"state": "OK",
"postal_code": "749609537",
"telephone_number": "918-575-1558"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2901 HIGHWAY 412 E",
"city": "SILOAM SPRINGS",
"state": "AR",
"postal_code": "727618673",
"telephone_number": "479-238-0257"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EAGLE",
"first_name": "ANGELA",
"credential": "OD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-11-02",
"last_updated": "2014-08-12",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "MO",
"license": "2013040188",
"primary": false
},
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "AR",
"license": "2692",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Siloam Springs, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2014; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.