NPIMap

Organization Active NPI

Eyecare Professionals PA

  • Ophthalmology Physician
  • Jackson, MS
National Provider Identifier
1932224748
Registry record updated Nov 27, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
14957 Issued in MS
Legal business name
EYECARE PROFESSIONALS PA
Practice address
1501 Lakeland Drive
Suite 100
Jackson, MS 39216-4848
Phone
(601) 366-1085
Fax
(601) 366-5186
NPI assigned
Mar 20, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 27, 2012

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

Authorized official

Name
Kirk R. Jeffreys III, M.D.NPI 1902998040
Title
President
Phone
(601) 366-1085

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 PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207W00000X 14957 MS Primary

Addresses

Primary practice location

1501 Lakeland Drive
Suite 100
Jackson, MS 39216-4848

Mailing address

1501 Lakeland Drive
Suite 100
Jackson, MS 39216-4848
Phone (601) 366-1085

Other identifiers 1

IdentifierTypeStateIssuer
09016216MedicaidMS

National Provider Directory

National Provider Directory

Locations

1501 Lakeland Dr
Jackson, MS 39216

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1174348800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1353974400000",
    "number": "1932224748",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1501 LAKELAND DRIVE",
            "address_2": "SUITE 100",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392164848",
            "telephone_number": "601-366-1085",
            "fax_number": "601-366-5186"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 LAKELAND DRIVE",
            "address_2": "SUITE 100",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392164848",
            "telephone_number": "601-366-1085",
            "fax_number": "601-366-5186"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EYECARE PROFESSIONALS PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-20",
        "last_updated": "2012-11-27",
        "status": "A",
        "authorized_official_last_name": "JEFFREYS",
        "authorized_official_first_name": "KIRK",
        "authorized_official_middle_name": "R.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "601-366-1085",
        "authorized_official_name_suffix": "III",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": "MS",
            "license": "14957",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "09016216",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2012; 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.