Optometric Eyecare, Inc

Primary specialty

OptometristTaxonomy code 152W00000X

License

046-008793 Issued in IL

Legal business name

OPTOMETRIC EYECARE, INC

Doing business as

Mt. Carmel EyeCare

Practice address

715 Chestnut St
Mount Carmel, IL 62863-1454

Phone

(618) 263-3362

Fax

(618) 263-6001

NPI assigned

Feb 27, 2009

Organization subpart

Yes

Parent organization

OPTOMETRIC EYECARE, INCAs reported in NPPES

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

Authorized official

Name

Dr. Clark E Deshon, O.D.NPI 1861482309

Title

President

Phone

(618) 263-3362

Specialties & licenses 1

Addresses

Other identifiers 4

Other names 1

• Mt. Carmel EyeCare Doing business as

Part of

Mt Carmel Eyecare

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• Optometric Eyecare Inc.

  • Optometrist
  • Olney, IL
  • NPI 1609041342
  NPPES parent name

Practitioners 1

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

• Clark Edward Deshon, O.D., F.A.A.O

  • Optometrist
  • Olney, IL
  • NPI 1861482309
  NPD Authorized official

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

{
    "created_epoch": "1235692800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1268092800000",
    "number": "1952541179",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "715 CHESTNUT ST",
            "city": "MOUNT CARMEL",
            "state": "IL",
            "postal_code": "628631454",
            "telephone_number": "618-263-3362",
            "fax_number": "618-263-6001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "715 CHESTNUT ST",
            "city": "MOUNT CARMEL",
            "state": "IL",
            "postal_code": "628631454",
            "telephone_number": "618-263-3362",
            "fax_number": "618-263-6001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OPTOMETRIC EYECARE, INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "OPTOMETRIC EYECARE, INC",
        "enumeration_date": "2009-02-27",
        "last_updated": "2010-03-09",
        "status": "A",
        "authorized_official_last_name": "DESHON",
        "authorized_official_first_name": "CLARK",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "618-263-3362",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046-008793",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "046008793",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "5290131",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD OF IL",
            "identifier": "09327152",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PALMETTO GBA - RAILROAD MEDICARE",
            "identifier": "1861482309",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mt. Carmel EyeCare",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• James Bradley O'Neal, M.S.
• Kim E O'Neal, LPC
• Oakview Nursing & Rehabilitation LLC
• Adrian Jonel Ola, A.T.C., L.A.T.
• Kamatchi Ondiveerappan, MD
• Carol Sue Overton
• Stephanie Marie Owen, FNP-C
• Priss Parmenter, BS
• Danielle Peach, LCSW
• Kasey Leigh Pearson, PA-C

• Optometrist in Mount Carmel, IL
• Providers in Mount Carmel, IL by specialty
• Optometrist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2010; 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.