Jim B Lieblong, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

2265 Issued in AR

Practice address

2800 W Main
Russellville, AR 72801

Phone

(479) 968-2020

Fax

(479) 968-8803

NPI assigned

Oct 5, 2005

Last updated

May 11, 2011By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in AR

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

Specialty

Optometry

Education

Southern College of Optometry, 1979

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Lieblong Eye Clinic PAGroup PAC ID 5395862320, 2 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

17.5 of 100Reported as individual

Quality

35

Improvement activities

0

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jlieblong192648@lieblongeyeclinic.emadirect.md

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.

• Lieblong Eye Clinic, PA

  • Customized Equipment (DME)
  • Russellville, AR
  • NPI 1710167143

  Optometrist

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1128470400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1305072000000",
    "number": "1750378691",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2800 W MAIN",
            "city": "RUSSELLVILLE",
            "state": "AR",
            "postal_code": "72801",
            "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",
            "city": "RUSSELLVILLE",
            "state": "AR",
            "postal_code": "72801",
            "telephone_number": "479-968-2020",
            "fax_number": "479-968-8803"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIEBLONG",
        "first_name": "JIM",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-10-05",
        "last_updated": "2011-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "AR",
            "license": "2265",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "103901722",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "QUALCHOICE",
            "identifier": "16617000041",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Katherine Lewis, RECOVERY ASSISTANT
• Lindsay Lewis
• Shae Mackenzie Lewis, PT, DPT
• Taylor N Lichty
• Lieblong Eye Clinic, PA
• Misty Rose Liles
• Thomas Lilley
• Timothy Lim, AU.D.
• Lincare Inc
• Linda J Yerina LCSW LLC

• Optometrist in Russellville, AR
• Providers in Russellville, AR by specialty
• Optometrist in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.