Individual provider Active NPI

Timothy C Hougland, O.D.

  • Optometrist
  • Jefferson City, MO
National Provider Identifier
1760776140
Registry record updated Aug 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2011018572 Issued in MO
Practice address
1445 Christy Dr Ste a
Jefferson City, MO 65101-2853
Phone
(573) 659-5560
Fax
(573) 659-5561
NPI assigned
Jun 3, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 23, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2011018572 MO Primary

Addresses

Primary practice location

1445 Christy Dr Ste a
Jefferson City, MO 65101-2853

Mailing address

1445 Christy Dr Ste a
Jefferson City, MO 65101-2853
Phone (573) 659-5560

Other identifiers 2

IdentifierTypeStateIssuer
12273374OtherCAQH
2011018572OtherMOLICENSE

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address tim1@centralmoeyecare.eyeclinicdirect.net Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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
I20110728000540 MO Practitioner - Optometry 5496923898 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University of Missouri St Louis - School of Optometry, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Central Missouri Eyecare Associates LLCGroup PAC ID 7810372513, 3 clinicians

Practice addresses (Care Compare)

1445 Christy Dr
Suite a
Jefferson City, MO 65101-2853
Phone 57365955601005

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery11

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Central Missouri Vision Center Optometrist CurrentSince Jul 22, 2011 Accepting new patients
Central Missouri Eyecare Associates LLC Optometrist CurrentSince Aug 31, 2022 Accepting new patients
Central Missouri Dermatology Associates, LLP PastSince May 1, 2023 Accepting new patients

Locations

1705 Christy Dr
Ste 208
Jefferson Cty, MO 65101
Phone (573) 644-9955

1445 Christy Dr
Ste A
Jefferson Cty, MO 65101
Phone (573) 659-5560

1445 Christy Dr
#A
Jefferson Cty, MO 65101
Phone (573) 659-5560

1445 Christy Dr
Jefferson Cty, MO 65101
Phone (573) 636-3483

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1307059200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661212800000",
    "number": "1760776140",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1445 CHRISTY DR STE A",
            "city": "JEFFERSON CITY",
            "state": "MO",
            "postal_code": "651012853",
            "telephone_number": "573-659-5560",
            "fax_number": "573-659-5561"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1445 CHRISTY DR STE A",
            "city": "JEFFERSON CITY",
            "state": "MO",
            "postal_code": "651012853",
            "telephone_number": "573-659-5560",
            "fax_number": "573-659-5561"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOUGLAND",
        "first_name": "TIMOTHY",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-06-03",
        "last_updated": "2022-08-23",
        "certification_date": "2022-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MO",
            "license": "2011018572",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "12273374",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "2011018572",
            "state": "MO"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tim1@centralmoeyecare.eyeclinicdirect.net",
            "affiliation": "N",
            "endpointDescription": "direct secure email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1445 Christy Dr Ste A",
            "city": "Jefferson City",
            "state": "MO",
            "country_code": "US",
            "postal_code": "651012853",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Jefferson City, MO

Sources for this page

Verify at the official NPI Registry.