Individual provider Active NPI

Charles Wilson Pope, O.D.

  • Optometrist
  • Camden, AR
National Provider Identifier
1609953827
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2563 Issued in AR
Practice address
130 Eagle Ave
Camden, AR 71701-3711
Phone
(870) 836-6886
Fax
(870) 836-2345
NPI assigned
Nov 1, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2563 AR Primary

Addresses

Primary practice location

130 Eagle Ave
Camden, AR 71701-3711

Mailing address

130 Eagle Ave
Camden, AR 71701-3711
Phone (870) 836-6886

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051116001063 AR Practitioner - Optometry 6800815002 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern College of Optometry, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Charles G Pope OD PAGroup PAC ID 6002838802, 2 clinicians

Practice addresses (Care Compare)

1120 S Main St
Malvern, AR 72104-5224
Phone (501) 332-2012

Merit-based Incentive Payment System (MIPS)

Final score
0 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
0

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery68

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2563ARMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Charles G Pope Odpa Optometrist CurrentSince Aug 1, 2005 Accepting new patients

Locations

130 Eagle Ave
Camden, AR 71701
Phone (870) 836-6886

1120 S Main St
Malvern, AR 72104
Phone (501) 332-2012

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1609953827",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 EAGLE AVE",
            "city": "CAMDEN",
            "state": "AR",
            "postal_code": "717013711",
            "telephone_number": "870-836-6886",
            "fax_number": "870-836-2345"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 EAGLE AVE",
            "city": "CAMDEN",
            "state": "AR",
            "postal_code": "717013711",
            "telephone_number": "870-836-6886",
            "fax_number": "870-836-2345"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POPE",
        "first_name": "CHARLES",
        "middle_name": "WILSON",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "AR",
            "license": "2563",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Camden, AR

Sources for this page

Verify at the official NPI Registry.