NPIMap

Organization Active NPI

Cherokee Eye Clinic, P.C.

  • Optometrist
  • Centre, AL
National Provider Identifier
1851403315
Registry record updated Jun 8, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
S-542-TA-135 Issued in AL
Legal business name
CHEROKEE EYE CLINIC, P.C.
Practice address
280 W Main St
Centre, AL 35960-1326
Phone
(256) 927-4030
Fax
(256) 927-2586
NPI assigned
Aug 31, 2006
Last updated
Jun 8, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 8, 2010

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

Authorized official

Name
Dr. Myron Wilson, O.D.NPI 1922110758
Title
Owner
Phone
(256) 927-4030

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
Optometrist 152W00000X S-542-TA-135 AL Primary

Addresses

Primary practice location

280 W Main St
Centre, AL 35960-1326

Mailing address

280 W Main St
Centre, AL 35960-1326
Phone (256) 927-4030

Other identifiers 3

IdentifierTypeStateIssuer
000059743MedicaidAL
51059743OtherALBLUE CROSS/BLUE SHIELD
5947260OtherALAETNA

National Provider Directory

National Provider Directory

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": "1156982400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1275955200000",
    "number": "1851403315",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "280 W MAIN ST",
            "city": "CENTRE",
            "state": "AL",
            "postal_code": "359601326",
            "telephone_number": "256-927-4030",
            "fax_number": "256-927-2586"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "280 W MAIN ST",
            "city": "CENTRE",
            "state": "AL",
            "postal_code": "359601326",
            "telephone_number": "256-927-4030",
            "fax_number": "256-927-2586"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHEROKEE EYE CLINIC, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-31",
        "last_updated": "2010-06-08",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "MYRON",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "256-927-4030",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "AL",
            "license": "S-542-TA-135",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000059743",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS/BLUE SHIELD",
            "identifier": "51059743",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "5947260",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Centre, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2010; 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.