Chris E Deitrick, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

2516 Issued in AR

Practice address

101 Case Commons Dr.
Mountain View, AR 72560

Phone

(870) 269-3610

Fax

(870) 269-5086

NPI assigned

Jul 8, 2005

Last updated

Aug 14, 2023By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 5

Medicare fee-for-service enrollment

Enrolled in AR

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

Southern College of Optometry, 2001

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

0 of 100Reported as individual

Quality

0

Improvement activities

0

Procedures performed for Medicare patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Chris Deitrick OD PA

  dba Mountain View Eye Care

  • Corneal and Contact Management Optometrist
  • Mountain View, AR
  • NPI 1780773481
  Medicare reassignment NPD

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

{
    "created_epoch": "1120780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691971200000",
    "number": "1669470183",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1460",
            "address_2": "101 CASE COMMONS DRIVE",
            "city": "MOUNTAIN VIEW",
            "state": "AR",
            "postal_code": "725601460",
            "telephone_number": "870-269-3610",
            "fax_number": "870-269-5086"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 CASE COMMONS DR.",
            "city": "MOUNTAIN VIEW",
            "state": "AR",
            "postal_code": "72560",
            "telephone_number": "870-269-3610",
            "fax_number": "870-269-5086"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEITRICK",
        "first_name": "CHRIS",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-07-08",
        "last_updated": "2023-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "AR",
            "license": "2516",
            "primary": true
        },
        {
            "code": "152WC0802X",
            "taxonomy_group": "",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "AR",
            "license": "2516",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RR ID#",
            "identifier": "410049416",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE DMEPOS ID #",
            "identifier": "4709560001",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID #",
            "identifier": "431988740",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "QUALCHOICE ID #",
            "identifier": "19930000041",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "145299722",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Larissa Davis, RECOVERY ASSISTANT
• Rickie Davis
• Russell Davis
• Sheri N. Davis, A.P.R.N., FNP-C
• Tammara Ivy Davis, PTA
• Debra Devito, R.R.T.
• Sunny Dickson, RN
• Katherine Dillon
• Jacob William Dobbins, D.D.S.
• Sandra Douglas, CMP

• Optometrist in Mountain View, AR
• Providers in Mountain View, AR by specialty
• Optometrist in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2023; 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.