NPIMap

Organization Active NPI

Elite Eyecare Associates, PC

  • Optometrist
  • Anniston, AL
National Provider Identifier
1861663312
Registry record updated Aug 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
S514TA101 Issued in AL
Legal business name
ELITE EYECARE ASSOCIATES, PC
Practice address
425 E 10TH St
Suite C
Anniston, AL 36207-4787
Phone
(256) 236-7516
Fax
(256) 237-6730
NPI assigned
Mar 12, 2008
Organization subpart
No

Practitioners 3

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

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090211000798 AL Part B Supplier - Clinic/Group Practice 0648335406 Receives reassigned benefits from 3 practitioners
Practice locations: Anniston, AL

National Provider Directory

National Provider Directory

Locations

425 E 10th St
Ste C
Anniston, AL 36207
Phone (256) 236-7516

NPPES NPI Registry

Updated by the provider on Aug 30, 2021

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

Authorized official

Name
Angie Romine
Title
Ins. Billing Clerk
Phone
(256) 236-7516

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X S514TA101 AL Primary

Addresses

Primary practice location

425 E 10TH St
Suite C
Anniston, AL 36207-4787

Mailing address

425 E 10TH St
Suite C
Anniston, AL 36207-4787
Phone (256) 236-7516

Other identifiers 1

IdentifierTypeStateIssuer
000059777MedicaidAL

Other names 1

  • GARY W. MURRELL, O.D., P.C. Former legal business name

NPI Registry JSON

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

{
    "created_epoch": "1205280000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1630281600000",
    "number": "1861663312",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "425 E 10TH ST",
            "address_2": "SUITE C",
            "city": "ANNISTON",
            "state": "AL",
            "postal_code": "362074787",
            "telephone_number": "256-236-7516",
            "fax_number": "256-237-6730"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "425 E 10TH ST",
            "address_2": "SUITE C",
            "city": "ANNISTON",
            "state": "AL",
            "postal_code": "362074787",
            "telephone_number": "256-236-7516",
            "fax_number": "256-237-6730"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELITE EYECARE ASSOCIATES, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-12",
        "last_updated": "2021-08-30",
        "certification_date": "2021-08-30",
        "status": "A",
        "authorized_official_last_name": "ROMINE",
        "authorized_official_first_name": "ANGIE",
        "authorized_official_title_or_position": "INS. BILLING CLERK",
        "authorized_official_telephone_number": "256-236-7516"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "AL",
            "license": "S514TA101",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000059777",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "GARY W. MURRELL, O.D., P.C.",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "GARY W. MURRELL, O.D., P.C.",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Anniston, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2021; 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.