Greenville Eye Clinic P.a.

Primary specialty

OptometristTaxonomy code 152W00000X

License

460 Issued in MS

Legal business name

GREENVILLE EYE CLINIC P.A.

Practice address

239 S Washington Ave
Greenville, MS 38701-4234

Phone

(662) 332-0163

Fax

(662) 378-3394

NPI assigned

Apr 10, 2007

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ms. Ruth C Anderson

Title

Secretary

Phone

(662) 332-0163

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• The Eye Clinic Former legal business name

Medicare fee-for-service enrollment

Enrolled in MS

Enrollment records 1

Practitioners 3

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.

• Mary Lord Griffin, O.D.

  • Optometrist
  • Greenville, MS
  • NPI 1255472502
  Medicare reassignment Care Compare group
• Wilburn Lord Jr., O.D.

  • Optometrist
  • Greenville, MS
  • NPI 1548301864
  Medicare reassignment Care Compare group
• Nicholas Norris, OD

  • Optometrist
  • Greenville, MS
  • NPI 1386047116
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1176163200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1881817732",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "239 S WASHINGTON AVE",
            "city": "GREENVILLE",
            "state": "MS",
            "postal_code": "387014234",
            "telephone_number": "662-332-0163",
            "fax_number": "662-378-3394"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "239 S WASHINGTON AVE",
            "city": "GREENVILLE",
            "state": "MS",
            "postal_code": "387014234",
            "telephone_number": "662-332-0163",
            "fax_number": "662-378-3394"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREENVILLE EYE CLINIC P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-10",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ANDERSON",
        "authorized_official_first_name": "RUTH",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "SECRETARY",
        "authorized_official_telephone_number": "662-332-0163",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "MS",
            "license": "460",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00880088",
            "state": "MS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PALMETTO GBA",
            "identifier": "1160110001",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Eye Clinic",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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• Optometrist in Greenville, MS
• Providers in Greenville, MS by specialty
• Optometrist in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.