Kimberly Mathis-Harris

Primary specialty

Eyewear SupplierTaxonomy code 332H00000X

Legal business name

KIMBERLY MATHIS-HARRIS

Doing business as

The Eye Bar optics

Practice address

1439 W 103Rd St Ste 3
Chicago, IL 60643-2900

Phone

(773) 339-6556

Fax

(773) 701-6055

NPI assigned

May 27, 2021

Last updated

May 27, 2021By 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. Kimberly Maria Mathis-Harris, OPTICIANNPI 1619566627

Title

Owner

Phone

(773) 339-6556

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• The Eye Bar optics Doing business as

Electronic endpoints 1

Locations

Practitioners 1

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.

• Kimberly Maria Mathis-Harris

  • Optician
  • Chicago, IL
  • NPI 1619566627

  Eyewear Supplier

  NPD Authorized official

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

{
    "created_epoch": "1622073600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1622073600000",
    "number": "1730754169",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1439 W 103RD ST STE 3",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606432900",
            "telephone_number": "773-339-6556",
            "fax_number": "773-701-6055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1439 W 103RD ST STE 3",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606432900",
            "telephone_number": "773-339-6556",
            "fax_number": "773-701-6055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KIMBERLY MATHIS-HARRIS",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-05-27",
        "last_updated": "2021-05-27",
        "certification_date": "2021-05-27",
        "status": "A",
        "authorized_official_last_name": "MATHIS-HARRIS",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_middle_name": "MARIA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "773-339-6556",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "OPTICIAN"
    },
    "taxonomies": [
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1619566627",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Chicago",
            "affiliation": "N",
            "endpointDescription": "mail",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Mail",
            "address_1": "1439 W 103rd St Ste 3",
            "city": "Chicago",
            "state": "IL",
            "country_code": "US",
            "postal_code": "606432900",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "The Eye Bar optics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Eyewear Supplier in Chicago, IL
• Providers in Chicago, IL by specialty
• Eyewear Supplier in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.