Coleman Cataract and Eye Laser Surgery Center, Inc

Primary specialty

Ophthalmologic Surgery Clinic/CenterTaxonomy code 261QS0132X

Legal business name

COLEMAN CATARACT AND EYE LASER SURGERY CENTER, INC

Practice address

2005 Highway 82 W
Greenwood, MS 38930-2720

Phone

(662) 455-4523

Fax

(662) 455-3790

NPI assigned

Jul 12, 2005

Organization subpart

No

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

Authorized official

Name

Tara E Kelly

Title

Insurance Representative

Phone

(662) 455-4523

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in MS

Enrollment records 1

Other NPIs with the same Medicare PAC ID 1

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

• Coleman Cataract and Eye Laser Surgery Center, Inc.

  • Anesthesiology Physician
  • Greenwood, MS
  • NPI 1245480482

  5890863039

  Same PAC ID

Listed as

Coleman Cataract and Eye Laser Surgery Center IncCCN 25C0001041

Medicare certification status

ActiveFrom the Provider of Services file

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

CLIA laboratory certificates

Tax ID family

Coleman Cataract and Eye Laser Surgery Center Inc2 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.

• Coleman Cataract and Eye Laser Surgery Center, Inc.

  • Anesthesiology Physician
  • Greenwood, MS
  • NPI 1245480482
  NPD tax ID

Practitioners 4

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

• William F Reid, CRNA

  • Certified Registered Nurse Anesthetist
  • Greenwood, MS
  • NPI 1851332209

  MS, Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD
• Lee Walker Coleman, M.D.

  • Ophthalmology Physician
  • Greenwood, MS
  • NPI 1336147271
  NPD
• Michael Sykes

  • Certified Registered Nurse Anesthetist
  • Greenwood, MS
  • NPI 1184593931

  Nurse Anesthetist, Certified Registered

  NPD
• Tyler Blocker, CRNA

  • Certified Registered Nurse Anesthetist
  • Jackson, TN
  • NPI 1205269305

  Nurse Anesthetist, Certified Registered

  NPD

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

{
    "created_epoch": "1121126400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1219708800000",
    "number": "1639177751",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2005 HIGHWAY 82 W",
            "city": "GREENWOOD",
            "state": "MS",
            "postal_code": "389302720",
            "telephone_number": "662-455-4523",
            "fax_number": "662-455-3790"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2005 HIGHWAY 82 W",
            "city": "GREENWOOD",
            "state": "MS",
            "postal_code": "389302720",
            "telephone_number": "662-455-4523",
            "fax_number": "662-455-3790"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLEMAN CATARACT AND EYE LASER SURGERY CENTER, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-12",
        "last_updated": "2008-08-26",
        "status": "A",
        "authorized_official_last_name": "KELLY",
        "authorized_official_first_name": "TARA",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "INSURANCE REPRESENTATIVE",
        "authorized_official_telephone_number": "662-455-4523"
    },
    "taxonomies": [
        {
            "code": "261QS0132X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ophthalmologic Surgery",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "367500000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00770597",
            "state": "MS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "490005565",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lakeita A Cary
• April M. Castle, M.P.T.
• Central Mississippi Radiology
• Circle of Life Adult Day Center
• Rekeeda Latrice Cockhren
• Coleman Cataract and Eye Laser Surgery Center, Inc.
• Coleman Eye Center, PLLC
• Kerri Deanetra Coleman, PCMHT
• Lee Walker Coleman, M.D.
• Brenda Collins, NCC, LPC

• Ophthalmologic Surgery Clinic/Center in Greenwood, MS
• Providers in Greenwood, MS by specialty
• Ophthalmologic Surgery Clinic/Center in Mississippi

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