Organization Active NPI

Springfield Eye & Plastic Surgery

  • Ophthalmology Physician
  • Springfield, MO
National Provider Identifier
1821201641
Registry record updated Mar 13, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
2004008249 Issued in MO
Legal business name
SPRINGFIELD EYE & PLASTIC SURGERY
Practice address
2828 N National Ave
Suite E
Springfield, MO 65803-4306
Phone
(417) 837-4238
Fax
(417) 875-4728
NPI assigned
May 8, 2007
Last updated
Mar 13, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 13, 2013

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

Authorized official

Name
Brendon Delport, D.O.NPI 1194721100
Title
Owner
Phone
(417) 496-3664

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207W00000X 2004008249 MO Primary

Addresses

Primary practice location

2828 N National Ave
Suite E
Springfield, MO 65803-4306

Mailing address

PO Box 70
Ozark, MO 65721-0070
Phone (417) 837-4238

National Provider Directory

National Provider Directory

Locations

2828 N National Ave
Ste E
Springfield, MO 65803
Phone (417) 837-4087

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1178582400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1363132800000",
    "number": "1821201641",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 70",
            "city": "OZARK",
            "state": "MO",
            "postal_code": "657210070",
            "telephone_number": "417-837-4238",
            "fax_number": "417-875-4728"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2828 N NATIONAL AVE",
            "address_2": "SUITE E",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658034306",
            "telephone_number": "417-837-4238",
            "fax_number": "417-875-4728"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPRINGFIELD EYE & PLASTIC SURGERY",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-08",
        "last_updated": "2013-03-13",
        "status": "A",
        "authorized_official_last_name": "DELPORT",
        "authorized_official_first_name": "BRENDON",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "417-496-3664",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": "MO",
            "license": "2004008249",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2013; 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.