Organization Active NPI

Eastern Shore Eye Care, PC

Doing business as Eastern Shore Eye Care

  • Optometrist
  • Fairhope, AL
National Provider Identifier
1932294386
Registry record updated Jan 4, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2186 Issued in AL
Legal business name
EASTERN SHORE EYE CARE, PC
Doing business as
Eastern Shore Eye Care
Practice address
118 Lottie LN
Fairhope, AL 36532-2995
Phone
(251) 928-4076
Fax
(251) 928-9461
NPI assigned
Oct 3, 2006
Last updated
Jan 4, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 4, 2013

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

Authorized official

Name
Dr. Duane Michael Schrock, O.D.NPI 1114013166
Title
Owner/Optometrist
Phone
(251) 928-4076

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
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 2186 AL Primary

Addresses

Primary practice location

118 Lottie LN
Fairhope, AL 36532-2995

Mailing address

118 Lottie LN
Fairhope, AL 36532-2995
Phone (251) 928-4076

Other names 1

  • Eastern Shore Eye Care Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20051101000046 AL Part B Supplier - Clinic/Group Practice 7113944901 Receives reassigned benefits from 5 practitioners
Practice locations: Fairhope, AL

National Provider Directory

National Provider Directory

Locations

118 Lottie Ln
Fairhope, AL 36532
Phone (251) 928-4076

420 Eastern Shore Shopping Ctr
Fairhope, AL 36532
Phone (251) 928-4076

Practitioners & affiliated clinicians

Practitioners 6

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": "1159833600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1357257600000",
    "number": "1932294386",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "118 LOTTIE LN",
            "city": "FAIRHOPE",
            "state": "AL",
            "postal_code": "365322995",
            "telephone_number": "251-928-4076",
            "fax_number": "251-928-9461"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "118 LOTTIE LN",
            "city": "FAIRHOPE",
            "state": "AL",
            "postal_code": "365322995",
            "telephone_number": "251-928-4076",
            "fax_number": "251-928-9461"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EASTERN SHORE EYE CARE, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-03",
        "last_updated": "2013-01-04",
        "status": "A",
        "authorized_official_last_name": "SCHROCK",
        "authorized_official_first_name": "DUANE",
        "authorized_official_middle_name": "MICHAEL",
        "authorized_official_title_or_position": "OWNER/OPTOMETRIST",
        "authorized_official_telephone_number": "251-928-4076",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "AL",
            "license": "2186",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Eastern Shore Eye Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fairhope, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2013; 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.