Organization Active NPI

Marshall Family Eyecare PLLC

  • Optometrist
  • Marshall, AR
National Provider Identifier
1609450055
Registry record updated Jul 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
MARSHALL FAMILY EYECARE PLLC
Practice address
303 East Main Street
Marshall, AR 72650
Phone
(870) 448-2233
Fax
(870) 448-5006
NPI assigned
May 11, 2021
Last updated
Jul 30, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 30, 2021

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

Authorized official

Name
Carylene Dowell Gentry, ODNPI 1770701690
Title
Sole Member
Phone
(870) 448-7362

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X NU Primary

Addresses

Primary practice location

303 East Main Street
Marshall, AR 72650

Mailing address

PO Box 1109
Marshall, AR 72650-1109
Phone (870) 448-2233

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20211019001842 AR Part B Supplier - Clinic/Group Practice 4587052808 Receives reassigned benefits from 1 practitioner
Practice locations: Marshall, AR

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

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": "1620691200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1627603200000",
    "number": "1609450055",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1109",
            "city": "MARSHALL",
            "state": "AR",
            "postal_code": "726501109",
            "telephone_number": "870-448-2233",
            "fax_number": "870-448-5006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "303 EAST MAIN STREET",
            "city": "MARSHALL",
            "state": "AR",
            "postal_code": "72650",
            "telephone_number": "870-448-2233",
            "fax_number": "870-448-5006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARSHALL FAMILY EYECARE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-05-11",
        "last_updated": "2021-07-30",
        "certification_date": "2021-07-30",
        "status": "A",
        "authorized_official_last_name": "GENTRY",
        "authorized_official_first_name": "CARYLENE",
        "authorized_official_middle_name": "DOWELL",
        "authorized_official_title_or_position": "SOLE MEMBER",
        "authorized_official_telephone_number": "870-448-7362",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marshall, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2021; 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.