Eyecare Surgery Center, LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

License

14957 Issued in MS

Legal business name

EYECARE SURGERY CENTER, LLC

Practice address

1501 Lakeland Dr Ste 101
Jackson, MS 39216-4839

Phone

(601) 366-1085

Fax

(601) 366-5186

NPI assigned

Jan 17, 2013

Organization subpart

No

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

Authorized official

Name

Dr. Kirk R Jeffreys III, M.D.NPI 1902998040

Title

Owner

Phone

(601) 366-1085

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MS

Enrollment records 1

Listed as

Eyecare Surgery Center LLCCCN 25C0001083

Medicare certification status

ActiveFrom the Provider of Services file

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

CLIA laboratory certificates

Locations

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kirk R. Jeffreys III, M.D.

  • Ophthalmology Physician
  • Jackson, MS
  • NPI 1902998040
  Medicare reassignment NPD Authorized official
• David Franklin Jones, M.D.

  • Ophthalmology Physician
  • Jackson, MS
  • NPI 1295955672
  Medicare reassignment NPD
• Kyle Lewis, M. D.

  • Ophthalmic Plastic and Reconstructive Surgery Physician
  • Jackson, MS
  • NPI 1902017924
  Medicare reassignment NPD
• Farrah D Newman, M. D.

  • Ophthalmology Physician
  • Jackson, MS
  • NPI 1568673689
  Medicare reassignment NPD
• Troy Michael Newman, M.D.

  • Ophthalmology Physician
  • Jackson, MS
  • NPI 1427156637
  Medicare reassignment NPD
• John Benton Lyon, M.D.

  • Specialist
  • Laurel, MS
  • NPI 1336208305
  Medicare reassignment

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

{
    "created_epoch": "1358380800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1358380800000",
    "number": "1821336371",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1501 LAKELAND DR STE 101",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392164839",
            "telephone_number": "601-366-1085",
            "fax_number": "601-366-5186"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 LAKELAND DR STE 101",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392164839",
            "telephone_number": "601-366-1085",
            "fax_number": "601-366-5186"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EYECARE SURGERY CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-01-17",
        "last_updated": "2013-01-17",
        "status": "A",
        "authorized_official_last_name": "JEFFREYS",
        "authorized_official_first_name": "KIRK",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "601-366-1085",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "III",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "MS",
            "license": "14957",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00120588",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Executive Diagnostics LLC
• Eyecare Professionals of Mississippi, PLLC
• Eyecare Professionals PA
• Eyemart Express LLC
• Eyemart Express, LTD.
• Eyemasters Inc
• Sharon Elaine Ezell, NP
• Gabrielle Facey, M.D.

• Ambulatory Surgical Clinic/Center in Jackson, MS
• Providers in Jackson, MS by specialty
• Ambulatory Surgical Clinic/Center in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2013; 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.