Charles D Pearson, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

046-008903 Issued in IL

Practice address

6560 E State St
Rockford, IL 61108-2545

Phone

(815) 227-1820

Fax

(815) 227-1986

NPI assigned

May 15, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

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

Specialty

Optometry

Education

Illinois College of Optometry at Chicago, 1995

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Northern Illinois Optical Co., Inc.Group PAC ID 0941381537, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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

• Northern Illinois Optical Co., Inc.

  • Optician
  • Rockford, IL
  • NPI 1639252273

  Optometrist

  Medicare reassignment Care Compare group NPD
• Shopko Stores Operating Co. LLC

  • Eyewear Supplier
  • Albert Lea, MN
  • NPI 1528010642
  NPD (past)

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

{
    "created_epoch": "1147651200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1282521600000",
    "number": "1639120488",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6560 E STATE ST",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611082545",
            "telephone_number": "815-227-1820",
            "fax_number": "815-227-1986"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6560 E STATE ST",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611082545",
            "telephone_number": "815-227-1820",
            "fax_number": "815-227-1986"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEARSON",
        "first_name": "CHARLES",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-15",
        "last_updated": "2010-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046-008903",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Peak Medical Home Care Inc.
• Peak Personnel, Inc.
• Pearle Vision Inc
• Matthew Louis Pearlman, LSW
• Pearson Vision Care, SC
• Drew W Pearson, APN
• James Henry Peck, BC-HIS
• Tracy Barrett Peck, P.T.
• Jason Andrew Peckels, M.S.ED., L.P.C.
• Prakash Pedapati

• Optometrist in Rockford, IL
• Providers in Rockford, IL by specialty
• Optometrist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.