Fountains Eyecare Center, PC

Primary specialty

OptometristTaxonomy code 152W00000X

License

046-008905 Issued in IL

Legal business name

FOUNTAINS EYECARE CENTER, PC

Practice address

314 Fountains Pkwy
Suite D
Fairview Heights, IL 62208-2165

Phone

(618) 622-3013

NPI assigned

Jul 21, 2009

Organization subpart

No

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

Authorized official

Name

Dr. Wayne Eric Jones, OD

Title

President

Phone

(618) 622-3013

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1248134400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1291334400000",
    "number": "1912137266",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "314 FOUNTAINS PKWY",
            "address_2": "SUITE D",
            "city": "FAIRVIEW HEIGHTS",
            "state": "IL",
            "postal_code": "622082165",
            "telephone_number": "618-622-3013"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "314 FOUNTAINS PKWY",
            "address_2": "SUITE D",
            "city": "FAIRVIEW HEIGHTS",
            "state": "IL",
            "postal_code": "622082165",
            "telephone_number": "618-622-3013"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOUNTAINS EYECARE CENTER, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-07-21",
        "last_updated": "2010-12-03",
        "status": "A",
        "authorized_official_last_name": "JONES",
        "authorized_official_first_name": "WAYNE",
        "authorized_official_middle_name": "ERIC",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "618-622-3013",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046-008905",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Optometrist in Fairview Heights, IL
• Providers in Fairview Heights, IL by specialty
• Optometrist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 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.