Individual provider Active NPI

Abigail Ellen Sharp, OD

  • Optometrist
  • Rock Island, IL
National Provider Identifier
1639665540
Registry record updated Feb 5, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
046011202 Issued in IL
Practice address
2501 24TH St
Rock Island, IL 61201
Phone
(309) 788-0604
Fax
(309) 788-0611
NPI assigned
Jul 3, 2018
Last updated
Feb 5, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 5, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 046011202 IL Primary

Addresses

Primary practice location

2501 24TH St
Rock Island, IL 61201

Mailing address

2501 24TH St
Rock Island, IL 61201
Phone (309) 788-0604

Other practice location 1

106 S College Ave
Aledo, IL 61231-1626
Phone (309) 582-2421

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20180725001956 IL Practitioner - Optometry 9335496124 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Illinois College of Optometry at Chicago, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Rock Island Optometric Center LTDGroup PAC ID 1951428184, 5 clinicians

Practice addresses (Care Compare)

2501 24TH St
Rock Island, IL 61201-5300
Phone (309) 788-0604

Merit-based Incentive Payment System (MIPS)

Final score
86.5 of 100Reported as group
Quality
73
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
046011202ILMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Rock Island Optometric Center LTD Optometrist CurrentSince Jun 6, 2018 Accepting new patients

Locations

106 S College Ave
Aledo, IL 61231
Phone (309) 582-2421

2501 24th St
Rock Island, IL 61201
Phone (309) 786-1226

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": "1530576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612483200000",
    "number": "1639665540",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2501 24TH ST",
            "city": "ROCK ISLAND",
            "state": "IL",
            "postal_code": "61201",
            "telephone_number": "309-788-0604",
            "fax_number": "309-788-0611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2501 24TH ST",
            "city": "ROCK ISLAND",
            "state": "IL",
            "postal_code": "61201",
            "telephone_number": "309-788-0604",
            "fax_number": "309-788-0611"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "106 S College Ave",
            "address_purpose": "LOCATION",
            "city": "Aledo",
            "state": "IL",
            "postal_code": "612311626",
            "country_code": "US",
            "telephone_number": "309-582-2421",
            "fax_number": "309-582-2272",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHARP",
        "first_name": "ABIGAIL",
        "middle_name": "ELLEN",
        "name_prefix": "Ms.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-03",
        "last_updated": "2021-02-05",
        "certification_date": "2021-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046011202",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rock Island, IL

Sources for this page

Verify at the official NPI Registry.