NPIMap

Organization Active NPI

Eyecare Associates, Inc.

  • Eyewear Supplier
  • Birmingham, AL
National Provider Identifier
1710012877
Registry record updated Jul 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Eyewear SupplierTaxonomy code 332H00000X
License
S462TA018 Issued in AL
Legal business name
EYECARE ASSOCIATES, INC.
Practice address
3165 Green Valley Rd
Birmingham, AL 35243-5262
Phone
(636) 200-4393
Fax
(205) 967-2119
NPI assigned
Feb 22, 2007
Last updated
Jul 9, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2024

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

Authorized official

Name
Charles K Brown, ODNPI 1588652242
Title
Doctor
Phone
(205) 967-2103

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 4

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 152W00000X S462TA018 AL
OptometristGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 152W00000X SB75TA798 AL
Eyewear Supplier 332H00000X S462TA018 AL Primary
Eyewear Supplier 332H00000X SB75TA798 AL

Addresses

Primary practice location

3165 Green Valley Rd
Birmingham, AL 35243-5262

Mailing address

PO Box 207243
Dallas, TX 75320-7255
Phone (636) 200-4393

Other identifiers 2

IdentifierTypeStateIssuer
1578724647OtherALINDIVIDUAL NPI
158652242OtherALINDIVIDUAL NPI

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040823000825 AL Part B Supplier - Clinic/Group Practice 0749254001 Receives reassigned benefits from 88 practitioners
33 other NPIs on this enrollment
Practice locations: Huntsville, AL; Luverne, AL; Madison, AL; Mobile, AL; Montgomery, AL; Moody, AL; Northport, AL; Ozark, AL…

Other NPIs with the same Medicare PAC ID 3

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 33

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

View all 33

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 89

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.

View all 89

NPI Registry JSON

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

{
    "created_epoch": "1172102400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1720483200000",
    "number": "1710012877",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 207243",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753207255",
            "telephone_number": "636-200-4393",
            "fax_number": "636-527-0766"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3165 GREEN VALLEY RD",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352435262",
            "telephone_number": "636-200-4393",
            "fax_number": "205-967-2119"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EYECARE ASSOCIATES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-22",
        "last_updated": "2024-07-09",
        "certification_date": "2024-07-09",
        "status": "A",
        "authorized_official_last_name": "BROWN",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "DOCTOR",
        "authorized_official_telephone_number": "205-967-2103",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": "AL",
            "license": "S462TA018",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": "AL",
            "license": "SB75TA798",
            "primary": false
        },
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": "AL",
            "license": "S462TA018",
            "primary": true
        },
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": "AL",
            "license": "SB75TA798",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL NPI",
            "identifier": "1578724647",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL NPI",
            "identifier": "158652242",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Birmingham, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2024; 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.