Organization Active NPI

Starkville Eye Clinic Inc

  • Optometrist
  • Starkville, MS
National Provider Identifier
1669721247
Registry record updated Aug 29, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
767 Issued in MS
Legal business name
STARKVILLE EYE CLINIC INC
Practice address
1085 C Stark Road
Suite C
Starkville, MS 39759
Phone
(662) 320-6636
Fax
(662) 320-3838
NPI assigned
Aug 29, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 29, 2012

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

Authorized official

Name
Dr. Sherylan Anne Webb, O.D.NPI 1699857771
Title
Owner
Phone
(662) 320-6636

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 767 MS Primary

Addresses

Primary practice location

1085 C Stark Road
Suite C
Starkville, MS 39759

Mailing address

1085 C Stark Road
Suite C
Starkville, MS 39759
Phone (662) 320-6636

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130507000596 MS Part B Supplier - Clinic/Group Practice 5395982508 Receives reassigned benefits from 1 practitioner
Practice locations: Starkville, MS

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1346198400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1346198400000",
    "number": "1669721247",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1085 C STARK ROAD",
            "address_2": "SUITE C",
            "city": "STARKVILLE",
            "state": "MS",
            "postal_code": "39759",
            "telephone_number": "662-320-6636",
            "fax_number": "662-320-3838"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1085 C STARK ROAD",
            "address_2": "SUITE C",
            "city": "STARKVILLE",
            "state": "MS",
            "postal_code": "39759",
            "telephone_number": "662-320-6636",
            "fax_number": "662-320-3838"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STARKVILLE EYE CLINIC INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-08-29",
        "last_updated": "2012-08-29",
        "status": "A",
        "authorized_official_last_name": "WEBB",
        "authorized_official_first_name": "SHERYLAN",
        "authorized_official_middle_name": "ANNE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "662-320-6636",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "MS",
            "license": "767",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Starkville, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.