Organization Active NPI

Stilley Eye Associates, P.C.

  • Optometrist
  • Joplin, MO
National Provider Identifier
1902000466
Registry record updated Oct 20, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
STILLEY EYE ASSOCIATES, P.C.
Practice address
1602 S Range Line Rd
Joplin, MO 64804-3231
Phone
(417) 553-9903
Fax
(417) 627-9891
NPI assigned
Jun 11, 2007
Last updated
Oct 20, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 20, 2017

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

Authorized official

Name
Dr. Rebecca J. Stilley, O.D.NPI 1235224676
Title
O.D./Secretary
Phone
(417) 553-9903

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 2002015335 MO
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X Primary

Addresses

Primary practice location

1602 S Range Line Rd
Joplin, MO 64804-3231

Mailing address

1602 S Range Line Rd
Joplin, MO 64804-3231
Phone (417) 553-9903

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070613000085 MO Part B Supplier - Clinic/Group Practice 1850499971 Receives reassigned benefits from 2 practitioners
Practice locations: Joplin, MO

National Provider Directory

National Provider Directory

Locations

708 W 26TH St
Joplin, MO 64804
Phone (417) 781-9900

Practitioners & affiliated clinicians

Practitioners 7

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": "1181520000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1508457600000",
    "number": "1902000466",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1602 S RANGE LINE RD",
            "city": "JOPLIN",
            "state": "MO",
            "postal_code": "648043231",
            "telephone_number": "417-553-9903",
            "fax_number": "417-627-9891"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1602 S RANGE LINE RD",
            "city": "JOPLIN",
            "state": "MO",
            "postal_code": "648043231",
            "telephone_number": "417-553-9903",
            "fax_number": "417-627-9891"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STILLEY EYE ASSOCIATES, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-11",
        "last_updated": "2017-10-20",
        "status": "A",
        "authorized_official_last_name": "STILLEY",
        "authorized_official_first_name": "REBECCA",
        "authorized_official_middle_name": "J.",
        "authorized_official_title_or_position": "O.D./SECRETARY",
        "authorized_official_telephone_number": "417-553-9903",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "MO",
            "license": "2002015335",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Joplin, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2017; 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.