NPIMap

Organization Active NPI

Gailey Eye Clinic, LTD

  • Ophthalmic Technician/Technologist
  • Bloomington, IL
National Provider Identifier
1932156445
Registry record updated Apr 14, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmic Technician/TechnologistTaxonomy code 156FX1100X
Legal business name
GAILEY EYE CLINIC, LTD
Practice address
1008 N Main St
Bloomington, IL 61701-1784
Phone
(309) 829-5311
NPI assigned
May 28, 2006
Last updated
Apr 14, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 14, 2008

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

Authorized official

Name
Rebecca Cox
Title
Administrative Assistant
Phone
(309) 829-5311

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmic Technician/Technologist 156FX1100X IL Primary

Addresses

Primary practice location

1008 N Main St
Bloomington, IL 61701-1784

Mailing address

PO Box 757
Bloomington, IL 61702-0757
Phone (309) 829-5311

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040802000570 IL Part B Supplier - Clinic/Group Practice 2769469337 Receives reassigned benefits from 23 practitioners
5 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Peoria, IL; Watseka, IL; Springfield, IL; Peru, IL; Pekin, IL; Ottawa, IL; Galesburg, IL; Forsyth, IL…
O20100930063289 IL DME Supplier - Physician - Ophthalmology 2769469337 Practice locations: Bloomington, IL

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 5

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

National Provider Directory

National Provider Directory

Locations

2501 E College Ave
Bloomington, IL 61704
Phone (309) 661-1155

2501 E College Ave
Ste B
Bloomington, IL 61704
Phone (309) 661-9191

834 N Seminary St
Ste 103
Galesburg, IL 61401
Phone (309) 343-6000

220 E 1st St
Gibson City, IL 60936
Phone (217) 784-4912

123 N 8th St
Watseka, IL 60970
Phone (815) 432-2020

Practitioners & affiliated clinicians

Practitioners 19

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 19

NPI Registry JSON

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

{
    "created_epoch": "1148774400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208131200000",
    "number": "1932156445",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 757",
            "city": "BLOOMINGTON",
            "state": "IL",
            "postal_code": "617020757",
            "telephone_number": "309-829-5311",
            "fax_number": "309-827-8027"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1008 N MAIN ST",
            "city": "BLOOMINGTON",
            "state": "IL",
            "postal_code": "617011784",
            "telephone_number": "309-829-5311"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GAILEY EYE CLINIC, LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-28",
        "last_updated": "2008-04-14",
        "status": "A",
        "authorized_official_last_name": "COX",
        "authorized_official_first_name": "REBECCA",
        "authorized_official_title_or_position": "ADMINISTRATIVE ASSISTANT",
        "authorized_official_telephone_number": "309-829-5311"
    },
    "taxonomies": [
        {
            "code": "156FX1100X",
            "taxonomy_group": "",
            "desc": "Technician/Technologist, Ophthalmic",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bloomington, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2008; 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.