Active NPI
Complete Family Eyecare of West Frankfort, PC
- Optometrist
- West Frankfort, IL
National Provider Identifier
1669989281
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- Legal business name
- COMPLETE FAMILY EYECARE OF WEST FRANKFORT, PC
- Practice address
- 215 N Logan St Ste a
West Frankfort, IL 62896-2332 - Phone
- (618) 942-5465
- Fax
- (618) 942-7042
- NPI assigned
- Jan 4, 2018
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Chase Aaron Rudolph, OD
- Title
- President
- Phone
- (618) 942-5465
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | Primary |
Addresses
Primary practice location
215 N Logan St Ste a
West Frankfort, IL 62896-2332
Mailing address
PO Box 550
Carterville, IL 62918-0550
Phone (618) 942-5465
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20180409000325 | IL | Part B Supplier - Clinic/Group Practice | 3476816240 |
Receives reassigned benefits from 3 practitioners Practice locations: West Frankfort, IL |
National Provider Directory
National Provider DirectoryLocations
202 E Clark St
West Frankfort, IL 62896
Phone (618) 937-3126
Practitioners & affiliated clinicians
Practitioners 3
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": "1515024000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1644278400000",
"number": "1669989281",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 550",
"city": "CARTERVILLE",
"state": "IL",
"postal_code": "629180550",
"telephone_number": "618-942-5465",
"fax_number": "618-942-7042"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "215 N LOGAN ST STE A",
"city": "WEST FRANKFORT",
"state": "IL",
"postal_code": "628962332",
"telephone_number": "618-942-5465",
"fax_number": "618-942-7042"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "COMPLETE FAMILY EYECARE OF WEST FRANKFORT, PC",
"organizational_subpart": "NO",
"enumeration_date": "2018-01-04",
"last_updated": "2022-02-08",
"certification_date": "2022-02-08",
"status": "A",
"authorized_official_last_name": "RUDOLPH",
"authorized_official_first_name": "CHASE",
"authorized_official_middle_name": "AARON",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "618-942-5465",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "OD"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Optometrist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in West Frankfort, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2022; 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.