NPIMap

Organization Active NPI

Hattiesburg Eye Clinic, P.a.

Doing business as Hattiesburg Eye Clinic

  • Ophthalmology Physician
  • Hattiesburg, MS
National Provider Identifier
1922110949
Registry record updated Jun 18, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
Legal business name
HATTIESBURG EYE CLINIC, P.A.
Doing business as
Hattiesburg Eye Clinic
Practice address
100 Hospital Dr W
Hattiesburg, MS 39402-1334
Phone
(601) 268-5910
Fax
(601) 264-0659
NPI assigned
Aug 31, 2006
Last updated
Jun 18, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2008

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

Authorized official

Name
Stoney Williamson, M.D.NPI 1487762001
Title
President
Phone
(601) 268-5910

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X NU Primary

Addresses

Primary practice location

100 Hospital Dr W
Hattiesburg, MS 39402-1334

Mailing address

100 Hospital Dr W
Hattiesburg, MS 39402-1334
Phone (601) 268-5910

Other names 1

  • Hattiesburg Eye Clinic Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20080513000402 MS Part B Supplier - Clinic/Group Practice 4587733829 Receives reassigned benefits from 13 practitioners
2 other NPIs on this enrollment
Practice locations: Hattiesburg, MS; Laurel, MS
O20100930087956 MS DME Supplier - Physician - OphthalmologyDME Supplier - Physician - OptometristDME Supplier - Optician 4587733829 Practice locations: Hattiesburg, MS

Other NPIs on the same Medicare enrollment 2

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

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
25D2119248Hattiesburg Eye Clinic100 W Hospital Drive, Hattiesburg, MS 39402Certificate of waiverSep 21, 2026

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Hattiesburg Eye Clinic, P.a.100 Hospital Dr W, Hattiesburg, MS 39402-13346012685910219 Prosthetic Lenses: Conventional Eyeglasses|Prosthetic Lenses: Conventional Contact Lenses|Prosthetic Lenses: Prosthetics Cataract Lenses Accepts assignmentParticipating since Feb 16, 1993

National Provider Directory

National Provider Directory
Tax ID family
Hattiesburg Eye Clinic PA5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

Locations

426 Broad St
Columbia, MS 39429

105 Asbury Cir
Ste B
Hattiesburg, MS 39402
Phone (601) 450-0200

1711 W 20th St
Laurel, MS 39440
Phone (650) 660-1649

Practitioners & affiliated clinicians

Practitioners 13

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.

View all 13

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": "1213747200000",
    "number": "1922110949",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 HOSPITAL DR W",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "394021334",
            "telephone_number": "601-268-5910",
            "fax_number": "601-264-0659"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 HOSPITAL DR W",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "394021334",
            "telephone_number": "601-268-5910",
            "fax_number": "601-264-0659"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HATTIESBURG EYE CLINIC, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-31",
        "last_updated": "2008-06-18",
        "status": "A",
        "authorized_official_last_name": "WILLIAMSON",
        "authorized_official_first_name": "STONEY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "601-268-5910",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Hattiesburg Eye Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Hattiesburg, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.