NPIMap

Organization Active NPI

Family Eye Care Association, P.C.

  • Optometrist
  • Litchfield, IL
National Provider Identifier
1790865368
Registry record updated Apr 15, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
046008093 Issued in IL
Legal business name
FAMILY EYE CARE ASSOCIATION, P.C.
Practice address
510 W Union Ave
Litchfield, IL 62056-1937
Phone
(217) 324-3317
Fax
(217) 324-6833
NPI assigned
Oct 17, 2006
Last updated
Apr 15, 2009By the provider in NPPES
Organization subpart
Yes
Parent organization
FAMILY EYE CARE ASSOCIATION, P.C.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 15, 2009

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

Authorized official

Name
Douglas W. Johnson, O.D.
Title
President
Phone
(217) 324-3317

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 046008093 IL Primary

Addresses

Primary practice location

510 W Union Ave
Litchfield, IL 62056-1937

Mailing address

510 W Union Ave
Litchfield, IL 62056-1937
Phone (217) 324-3317

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20061205000419 IL Part B Supplier - Clinic/Group Practice 1951300771 Receives reassigned benefits from 3 practitioners
2 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Greenville, IL; Hillsboro, IL; Litchfield, IL
O20100930001875 IL DME Supplier - Physician - OptometristDME Supplier - Optician 1951300771 Practice locations: Litchfield, IL

Other NPIs with the same Medicare PAC ID 2

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Laboratory certificates & supplier records

Derived by NPIMap

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

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Family Eye Care Association, P.C.510 W Union Ave, Litchfield, IL 62056-1937(217) 324-3317 Prosthetic Lenses: Conventional Eyeglasses|Prosthetic Lenses: Conventional Contact Lenses Accepts assignmentParticipating since Jan 1, 1997

National Provider Directory

National Provider Directory
Tax ID family
Family Eye Care Assoc PC3 organizations share this tax ID, including this one
Part of
Family Eye Care Assoc PC

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Locations

510 W Union Ave
Litchfield, IL 62056
Phone (217) 324-3317

Practitioners & affiliated clinicians

Practitioners 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1161043200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1239753600000",
    "number": "1790865368",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "510 W UNION AVE",
            "city": "LITCHFIELD",
            "state": "IL",
            "postal_code": "620561937",
            "telephone_number": "217-324-3317",
            "fax_number": "217-324-6833"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "510 W UNION AVE",
            "city": "LITCHFIELD",
            "state": "IL",
            "postal_code": "620561937",
            "telephone_number": "217-324-3317",
            "fax_number": "217-324-6833"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY EYE CARE ASSOCIATION, P.C.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "FAMILY EYE CARE ASSOCIATION, P.C.",
        "enumeration_date": "2006-10-17",
        "last_updated": "2009-04-15",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "DOUGLAS",
        "authorized_official_middle_name": "W.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "217-324-3317",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046008093",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Litchfield, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2009; 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.