Individual provider Active NPI

Geoffrey M Sneddon, OD

  • Optometrist
  • Marion, IL
National Provider Identifier
1720026321
Registry record updated Oct 6, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
046-009938 Issued in IL
Practice address
1200 W Deyoung St
Marion, IL 62959-4437
Phone
(618) 993-5686
Fax
(618) 997-6250
NPI assigned
Jun 4, 2006
Last updated
Oct 6, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 6, 2008

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 4901004159 MI
Optometrist 152W00000X 046-009938 IL Primary

Addresses

Primary practice location

1200 W Deyoung St
Marion, IL 62959-4437

Mailing address

1200 W Deyoung St
Marion, IL 62959-4437
Phone (618) 993-5686

Other identifiers 12

IdentifierTypeStateIssuer
217445OtherEYEMED
0814870001OtherILMEDICARE NSC NUMBER
0814870010OtherILMEDICARE NSC NUMBER
900G510070OtherBCBS
P00434355OtherILMEDICARE RAILROAD
0814870011OtherILMEDICARE NSC NUMBER
944564620MedicaidMI
046009938MedicaidIL
0814870023OtherILMEDICARE NSC NUMBER
129094OtherHEALTH ALLIANCE
944553494MedicaidMI
0814870030OtherILMEDICARE NSC NUMBER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070427000206 IL Practitioner - Optometry 7113023706 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Illinois College of Optometry at Chicago, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Marion Eye Centers LTDGroup PAC ID 3072426774, 38 clinicians

Practice addresses (Care Compare)

101 E Main St
Fairfield, IL 62837-2027
Phone (618) 842-3228

1103 W Main St
Salem, IL 62881-1307
Phone (618) 548-0100

1200 W Deyoung St
Marion, IL 62959-4437
Phone (618) 993-5686

1204 US 45
Eldorado, IL 62930-1212
Phone (618) 273-6220

2900 Broadway St
A
Mount Vernon, IL 62864-2341
Phone (618) 244-2777

5 Eyecenter Dr
Harrisburg, IL 62946-3334
Phone (601) 252-5377

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
046-009938ILMDOptometrist
4901004159MIMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Marion Eye Centers LTD. Optometrist CurrentSince Apr 30, 2007 Accepting new patients
Marion Eye Centers LTD. Optometrist CurrentSince Apr 30, 2007 Accepting new patients

Locations

1201 W Main St
Carmi, IL 62821
Phone (618) 384-5112

899 E McCord St
Centralia, IL 62801
Phone (618) 532-1997

101 E Main St
Fairfield, IL 62837
Phone (618) 842-3228

1200 W Deyoung St
Marion, IL 62959
Phone 61899356861290

2900 Broadway St
#A
Mount Vernon, IL 62864
Phone (618) 244-2777

902 E Locust St
Olney, IL 62450
Phone (618) 392-2020

1103 W Main St
Salem, IL 62881
Phone (618) 548-0100

909 W Main St
West Frankfort, IL 62896
Phone (618) 372-6040

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1149379200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1223251200000",
    "number": "1720026321",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 W DEYOUNG ST",
            "city": "MARION",
            "state": "IL",
            "postal_code": "629594437",
            "telephone_number": "618-993-5686",
            "fax_number": "618-997-6250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 W DEYOUNG ST",
            "city": "MARION",
            "state": "IL",
            "postal_code": "629594437",
            "telephone_number": "618-993-5686",
            "fax_number": "618-997-6250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SNEDDON",
        "first_name": "GEOFFREY",
        "middle_name": "M",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-04",
        "last_updated": "2008-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MI",
            "license": "4901004159",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046-009938",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EYEMED",
            "identifier": "217445",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE NSC NUMBER",
            "identifier": "0814870001",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE NSC NUMBER",
            "identifier": "0814870010",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "900G510070",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "P00434355",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE NSC NUMBER",
            "identifier": "0814870011",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "944564620",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "046009938",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE NSC NUMBER",
            "identifier": "0814870023",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH ALLIANCE",
            "identifier": "129094",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "944553494",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE NSC NUMBER",
            "identifier": "0814870030",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Marion, IL

Sources for this page

Verify at the official NPI Registry.