NPIMap

Organization Active NPI

John D. Coble

Doing business as Eyecare of Greenville

  • Medical Specialty Clinic/Center
  • Greenville, TX
National Provider Identifier
1851403877
Registry record updated Sep 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Specialty Clinic/CenterTaxonomy code 261QM2500X
License
3622TG Issued in TX
Legal business name
JOHN D. COBLE
Doing business as
Eyecare of Greenville
Practice address
4501 Joe Ramsey Blvd E Ste 110
Greenville, TX 75401-7838
Phone
(903) 454-1886
Fax
(903) 455-3055
NPI assigned
Aug 31, 2006
Last updated
Sep 9, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2022

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

Authorized official

Name
John D Coble, ODNPI 1174507677
Title
Owner
Phone
(903) 454-1886

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Specialty Clinic/Center 261QM2500X 3622TG TX Primary
Optometrist 152W00000X NU

Addresses

Primary practice location

4501 Joe Ramsey Blvd E Ste 110
Greenville, TX 75401-7838

Mailing address

4501 Joe Ramsey Blvd E Ste 110
Greenville, TX 75401-7838
Phone (903) 454-1886

Other identifiers 1

IdentifierTypeStateIssuer
3093296-01MedicaidTX

Other names 1

  • Eyecare of Greenville Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100930074710 TX DME Supplier - Physician - Optometrist 1254390578 1 other NPI on this enrollment
Practice locations: Greenville, TX

Other NPIs on the same Medicare enrollment 1

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

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 9

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": "1662681600000",
    "number": "1851403877",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4501 JOE RAMSEY BLVD E STE 110",
            "city": "GREENVILLE",
            "state": "TX",
            "postal_code": "754017838",
            "telephone_number": "903-454-1886",
            "fax_number": "903-455-3055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4501 JOE RAMSEY BLVD E STE 110",
            "city": "GREENVILLE",
            "state": "TX",
            "postal_code": "754017838",
            "telephone_number": "903-454-1886",
            "fax_number": "903-455-3055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOHN D. COBLE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-31",
        "last_updated": "2022-09-09",
        "certification_date": "2022-09-09",
        "status": "A",
        "authorized_official_last_name": "COBLE",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "903-454-1886",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "TX",
            "license": "3622TG",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3093296-01",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Eyecare of Greenville",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Eyecare of Greenville",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Greenville, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.