Spencer Family Eye Care, LLC

Primary specialty

OptometristTaxonomy code 152W00000X

Legal business name

SPENCER FAMILY EYE CARE, LLC

Practice address

711 N Main St
Benton, IL 62812-1017

Phone

(618) 439-7256

Fax

(618) 439-7261

NPI assigned

Mar 14, 2021

Last updated

Mar 18, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Michael Spencer, ODNPI 1245688308

Title

Owner

Phone

(618) 439-7256

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL2 enrollments

Enrollment records 2

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

Medicare medical equipment & supply locations

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Michael Sebastian Spencer, O.D.

  • Optometrist
  • Benton, IL
  • NPI 1245688308
  Medicare reassignment Care Compare group NPD Authorized official
• Olivia Boehnke

  • Optometrist
  • Mount Vernon, IL
  • NPI 1174179584
  Medicare reassignment Care Compare group NPD
• David Keith Spencer, O.D.

  • Optometrist
  • Benton, IL
  • NPI 1750398467
  NPD

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

{
    "created_epoch": "1615680000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1616025600000",
    "number": "1639754328",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "711 N MAIN ST",
            "city": "BENTON",
            "state": "IL",
            "postal_code": "628121017",
            "telephone_number": "618-439-7256",
            "fax_number": "618-439-7261"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "711 N MAIN ST",
            "city": "BENTON",
            "state": "IL",
            "postal_code": "628121017",
            "telephone_number": "618-439-7256",
            "fax_number": "618-439-7261"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "410 W Randolph St",
            "address_purpose": "LOCATION",
            "city": "Mc Leansboro",
            "state": "IL",
            "postal_code": "628591280",
            "country_code": "US",
            "telephone_number": "618-643-5113",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SPENCER FAMILY EYE CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-03-14",
        "last_updated": "2021-03-18",
        "certification_date": "2021-03-18",
        "status": "A",
        "authorized_official_last_name": "SPENCER",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "618-439-7256",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Southern Illinois Hospital Services (Herrin Hospital)
• Southern Illinois Medical Services, NFP (Benton Community Healthcare)
• Southern Illinois Medical Services, NFP (Benton Community Healthcare)
• Southern Illinois Sport and Spine LLC
• Southern Illinois Therapy Services, PLLC
• David Keith Spencer, O.D.
• Michael Sebastian Spencer, O.D.
• Chelsea Steele
• Hannah Stock
• Stonebridge Nursing & Rehabilitation Center, LLC

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2021; 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.