Organization Active NPI

Mt Vernon Eye Clinic PLC

  • Optometrist
  • Mount Vernon, IA
National Provider Identifier
1578635686
Registry record updated Oct 29, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
MT VERNON EYE CLINIC PLC
Practice address
202 Glenn St
Mount Vernon, IA 52314-1588
Phone
(319) 895-8888
Fax
(319) 895-8889
NPI assigned
Nov 14, 2006
Last updated
Oct 29, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2008

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

Authorized official

Name
Peg L Flockhart
Title
Insurance Manager
Phone
(319) 895-8888

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X Primary

Addresses

Primary practice location

202 Glenn St
Mount Vernon, IA 52314-1588

Mailing address

202 Glenn St
Mount Vernon, IA 52314-1588
Phone (319) 895-8888

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040322000833 IA Part B Supplier - Clinic/Group Practice 2567353485 Receives reassigned benefits from 4 practitioners
Practice locations: Mount Vernon, IA
O20100930058281 IA DME Supplier - Physician - OptometristDME Supplier - Optician 2567353485 Practice locations: Mount Vernon, IA

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Mt Vernon Eye Clinic PLC202 Glenn St SE, Mount Vernon, IA 52314-1588(319) 895-8888 Prosthetic Lenses: Conventional Eyeglasses|Prosthetic Lenses: Conventional Contact Lenses Does not accept assignmentParticipating since Aug 23, 1999

National Provider Directory

National Provider Directory

Locations

202 Glenn St SE
Mount Vernon, IA 52314
Phone (319) 895-8888

Practitioners & affiliated clinicians

Practitioners 4

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": "1163462400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1225238400000",
    "number": "1578635686",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "202 GLENN ST",
            "city": "MOUNT VERNON",
            "state": "IA",
            "postal_code": "523141588",
            "telephone_number": "319-895-8888",
            "fax_number": "319-895-8889"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "202 GLENN ST",
            "city": "MOUNT VERNON",
            "state": "IA",
            "postal_code": "523141588",
            "telephone_number": "319-895-8888",
            "fax_number": "319-895-8889"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MT VERNON EYE CLINIC PLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-14",
        "last_updated": "2008-10-29",
        "status": "A",
        "authorized_official_last_name": "FLOCKHART",
        "authorized_official_first_name": "PEG",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "INSURANCE MANAGER",
        "authorized_official_telephone_number": "319-895-8888"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Vernon, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.

Verify at the official NPI Registry.