Individual provider Active NPI

Amber R Moreland, O.D.

  • Optometrist
  • Anna, IL
National Provider Identifier
1821089970
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Practice address
125 Leigh Ave
Anna, IL 62906-2203
Phone
(618) 833-9208
Fax
(618) 833-3142
NPI assigned
Oct 28, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X IL Primary
Optometrist 152W00000X IL

Addresses

Primary practice location

125 Leigh Ave
Anna, IL 62906-2203

Mailing address

740 Anna Nursery LN
Cobden, IL 62920-3671
Phone (618) 833-4690

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
I20051110000423 IL Practitioner - Optometry 2365469251 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Indiana University - School of Optometry, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

100 Peach Ridge Rd
Anna, IL 62906-2242
Phone (618) 833-9208

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery58

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
047-931404ILMDOptometrist
346-002250ILMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Moreland Eyecare LLC Optometrist CurrentSince May 21, 2007 Accepting new patients
Clarkson Optometry Inc Optometrist PastSince Jan 19, 2004 Accepting new patients

Locations

100 Peach Ridge Rd
Anna, IL 62906
Phone (618) 833-9208

125 Leigh Ave
Ste A
Anna, IL 62906
Phone (618) 833-9208

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1130457600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1821089970",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "740 ANNA NURSERY LN",
            "city": "COBDEN",
            "state": "IL",
            "postal_code": "629203671",
            "telephone_number": "618-833-4690",
            "fax_number": "618-833-3142"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 LEIGH AVE",
            "city": "ANNA",
            "state": "IL",
            "postal_code": "629062203",
            "telephone_number": "618-833-9208",
            "fax_number": "618-833-3142"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORELAND",
        "first_name": "AMBER",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-28",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": null,
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Anna, IL

Sources for this page

Verify at the official NPI Registry.