Lieblong Eye Clinic, PA

Primary specialty

Customized Equipment (DME)Taxonomy code 332BC3200X

License

2265 Issued in AR

Legal business name

LIEBLONG EYE CLINIC, PA

Practice address

2800 W Main St
Russellville, AR 72801-2449

Phone

(479) 968-2020

Fax

(479) 968-8803

NPI assigned

Nov 14, 2007

Last updated

May 12, 2011By 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

Mrs. Chloe Lieblong

Title

Office Manager

Phone

(479) 968-2020

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in AR2 enrollments

Enrollment records 2

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Medicare medical equipment & supply locations

Locations

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.

• Eryn Lewis, O.D.

  • Optometrist
  • Russellville, AR
  • NPI 1184359580
  Medicare reassignment Care Compare group NPD
• Jim B Lieblong, O.D.

  • Optometrist
  • Russellville, AR
  • NPI 1750378691
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1194998400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1305158400000",
    "number": "1710167143",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2800 W MAIN ST",
            "city": "RUSSELLVILLE",
            "state": "AR",
            "postal_code": "728012449",
            "telephone_number": "479-968-2020",
            "fax_number": "479-968-8803"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2800 W MAIN ST",
            "city": "RUSSELLVILLE",
            "state": "AR",
            "postal_code": "728012449",
            "telephone_number": "479-968-2020",
            "fax_number": "479-968-8803"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIEBLONG EYE CLINIC, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-14",
        "last_updated": "2011-05-12",
        "status": "A",
        "authorized_official_last_name": "LIEBLONG",
        "authorized_official_first_name": "CHLOE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "479-968-2020",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": "AR",
            "license": "2265",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "QUAL CHOICE",
            "identifier": "16617000041",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "103901722",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD RETIREMENT",
            "identifier": "410014279",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Herbert Anderson Lewis IV, M.D.
• Katherine Lewis, RECOVERY ASSISTANT
• Lindsay Lewis
• Shae Mackenzie Lewis, PT, DPT
• Taylor N Lichty
• Jim B Lieblong, O.D.
• Misty Rose Liles
• Thomas Lilley
• Timothy Lim, AU.D.
• Lincare Inc

• Customized Equipment (DME) in Russellville, AR
• Providers in Russellville, AR by specialty
• Customized Equipment (DME) in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.