Hattiesburg Eye Clinic, P.a.

Primary specialty

OptometristTaxonomy code 152W00000X

License

1428569T Issued in LA

Legal business name

HATTIESBURG EYE CLINIC, P.A.

Practice address

5901 Hwy 49 South
Hattiesburg, MS 39402

Phone

(601) 450-4733

NPI assigned

Jul 23, 2007

Last updated

Jul 23, 2007By 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

Eddie Smith

Title

Administrator

Phone

(601) 268-5910

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MS

Enrollment records 1

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Hattiesburg Eye Clinic, P.a.

  • Optometrist
  • Laurel, MS
  • NPI 1538369996

  O20080513000402

  Same enrollment
• Hattiesburg Eye Clinic, P.a.

  dba Hattiesburg Eye Clinic

  • Ophthalmology Physician
  • Hattiesburg, MS
  • NPI 1922110949

  O20080513000402

  Same enrollment

Practitioners 2

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.

• Charles David Richardson, M.D.

  • Ophthalmology Physician
  • Hattiesburg, MS
  • NPI 1568570117
  NPD
• Kimberly A Yeates, O.D.

  • Optometrist
  • Columbus, MS
  • NPI 1083804322
  NPD

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

{
    "created_epoch": "1185148800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1185148800000",
    "number": "1700086162",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 HOSPITAL DR W",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "394021334",
            "telephone_number": "601-268-5910"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5901 HWY 49 SOUTH",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "39402",
            "telephone_number": "601-450-4733"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HATTIESBURG EYE CLINIC, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-23",
        "last_updated": "2007-07-23",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "EDDIE",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "601-268-5910"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "LA",
            "license": "1428569T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hattiesburg Community Dental Center
• Hattiesburg Convalescent Home, Inc.
• Hattiesburg Convalescent Home, Inc.
• Hattiesburg Eye Clinic Cataract & Lasik Surgery Center, LLC
• Hattiesburg Eye Clinic Cataract & Lasik Surgery Center, LLC
• Hattiesburg Eye Clinic, P.a. (Hattiesburg Eye Clinic)
• Hattiesburg Gi Associates, PLLC
• Hattiesburg HB Medical Services LLC (Merit Health Wesley)
• Hattiesburg Health & Rehab Center LLC
• Hattiesburg High School and Community Clinic

• Optometrist in Hattiesburg, MS
• Providers in Hattiesburg, MS by specialty
• Optometrist in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2007; 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.