Organization Active NPI

Eye to Eye Optometry, Inc

  • Optometrist
  • Mexico, MO
National Provider Identifier
1952501223
Registry record updated Mar 6, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
T03285 Issued in MO
Legal business name
EYE TO EYE OPTOMETRY, INC
Practice address
201 S Muldrow St
Mexico, MO 65265-1980
Phone
(573) 581-8811
Fax
(573) 582-7007
NPI assigned
Jul 24, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 6, 2018

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

Authorized official

Name
Mr. James Williams, MBA
Title
Clinical Director
Phone
(573) 581-8811

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X T03285 MO Primary

Addresses

Primary practice location

201 S Muldrow St
Mexico, MO 65265-1980

Mailing address

321 W Promenade St
Mexico, MO 65265-2719
Phone (573) 581-8811

Other identifiers 1

IdentifierTypeStateIssuer
313780306MedicaidMO

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080730000254 MO Part B Supplier - Clinic/Group Practice 2961576624 Receives reassigned benefits from 1 practitioner
Practice locations: Mexico, MO

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1185235200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1520294400000",
    "number": "1952501223",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "321 W PROMENADE ST",
            "city": "MEXICO",
            "state": "MO",
            "postal_code": "652652719",
            "telephone_number": "573-581-8811",
            "fax_number": "573-582-7007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 S MULDROW ST",
            "city": "MEXICO",
            "state": "MO",
            "postal_code": "652651980",
            "telephone_number": "573-581-8811",
            "fax_number": "573-582-7007"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EYE TO EYE OPTOMETRY, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-24",
        "last_updated": "2018-03-06",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS",
        "authorized_official_first_name": "JAMES",
        "authorized_official_title_or_position": "CLINICAL DIRECTOR",
        "authorized_official_telephone_number": "573-581-8811",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MBA"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "MO",
            "license": "T03285",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "313780306",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mexico, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2018; 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.