NPIMap

Organization Active NPI

Crabtree and Merriman Dctrs of Optometry

Doing business as Jacobs & Crabtree Dctrs of Optometry

  • Corneal and Contact Management Optometrist
  • Carbondale, IL
National Provider Identifier
1558352641
Registry record updated Dec 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Corneal and Contact Management OptometristTaxonomy code 152WC0802X
License
046007399 Issued in IL
Legal business name
CRABTREE AND MERRIMAN DCTRS OF OPTOMETRY
Doing business as
Jacobs & Crabtree Dctrs of Optometry
Practice address
1001 N Beadle Dr
Ste 40
Carbondale, IL 62901-1018
Phone
(618) 529-4817
Fax
(618) 351-9024
NPI assigned
Oct 29, 2005
Last updated
Dec 6, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 6, 2022

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

Authorized official

Name
Dr. Paul C Jacobs, O.D.NPI 1255326500
Title
Partner
Phone
(618) 529-4817

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Corneal and Contact Management Optometrist 152WC0802X 046007399 IL Primary

Addresses

Primary practice location

1001 N Beadle Dr
Ste 40
Carbondale, IL 62901-1018

Mailing address

1508 Sioux Dr
Marion, IL 62959-5200
Phone (618) 993-8787

Other names 1

  • JACOBS & CRABTREE DCTRS OF OPTOMETRY Doing business as

National Provider Directory

National Provider Directory

Locations

1001 N Beadle Dr
Carbondale, IL 62901
Phone (618) 457-2123

1001 N Beadle Dr
Ste 40
Carbondale, IL 62901
Phone (618) 529-4817

Practitioners & affiliated clinicians

Practitioners 1

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": "1130544000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1670284800000",
    "number": "1558352641",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1508 SIOUX DR",
            "city": "MARION",
            "state": "IL",
            "postal_code": "629595200",
            "telephone_number": "618-993-8787",
            "fax_number": "618-997-6547"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 N BEADLE DR",
            "address_2": "STE 40",
            "city": "CARBONDALE",
            "state": "IL",
            "postal_code": "629011018",
            "telephone_number": "618-529-4817",
            "fax_number": "618-351-9024"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CRABTREE AND MERRIMAN DCTRS OF OPTOMETRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-29",
        "last_updated": "2022-12-06",
        "certification_date": "2022-12-06",
        "status": "A",
        "authorized_official_last_name": "JACOBS",
        "authorized_official_first_name": "PAUL",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "618-529-4817",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152WC0802X",
            "taxonomy_group": "",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "IL",
            "license": "046007399",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "JACOBS & CRABTREE DCTRS OF OPTOMETRY",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "JACOBS & CRABTREE DCTRS OF OPTOMETRY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Carbondale, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.