NPIMap

Organization Active NPI

Eyecare Professionals of Mississippi, PLLC

  • Ophthalmology Physician
  • Flowood, MS
National Provider Identifier
1629784269
Registry record updated Jan 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
Legal business name
EYECARE PROFESSIONALS OF MISSISSIPPI, PLLC
Practice address
240 Belle Meade PT
Flowood, MS 39232-3310
Phone
(601) 366-1085
Fax
(769) 867-9123
NPI assigned
Jan 26, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 26, 2023

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

Authorized official

Name
Kirk Jeffreys, MDNPI 1902998040
Title
President
Phone
(601) 366-1085

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
Ophthalmology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207W00000X Primary

Addresses

Primary practice location

240 Belle Meade PT
Flowood, MS 39232-3310

Mailing address

1501 Lakeland Dr Ste 100
Jackson, MS 39216-4869
Phone (601) 366-1085

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20240405001188 MS Part B Supplier - Clinic/Group Practice 1052759354 Receives reassigned benefits from 5 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Flowood, MS; Jackson, MS
O20250924000778 MS DME Supplier - Physician - Ophthalmology 1052759354 Practice locations: Flowood, MS

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Eyecare Professionals of Ms2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1501 Lakeland Dr
Ste 100
Jackson, MS 39216
Phone (601) 355-1085

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1674691200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1674691200000",
    "number": "1629784269",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1501 LAKELAND DR STE 100",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392164869",
            "telephone_number": "601-366-1085"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "240 BELLE MEADE PT",
            "city": "FLOWOOD",
            "state": "MS",
            "postal_code": "392323310",
            "telephone_number": "601-366-1085",
            "fax_number": "769-867-9123"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EYECARE PROFESSIONALS OF MISSISSIPPI, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-01-26",
        "last_updated": "2023-01-26",
        "certification_date": "2023-01-26",
        "status": "A",
        "authorized_official_last_name": "JEFFREYS",
        "authorized_official_first_name": "KIRK",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "601-366-1085",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Flowood, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2023; 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.