Belk Eye Clinic, PA
Organization Active NPI Optometrist · Gulfport, MS
NPI 1962575472 · NPPES record last updated Mar 31, 2014
Key facts
- NPI
- 1962575472
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Optometrist 152W00000X
- License
- 573 (MS)
- Legal business name
- BELK EYE CLINIC, PA
- Practice address
- 12199 Highway 49 Ste 100
Gulfport, MS 39503-3167 - Phone
- (228) 832-1832
- NPI assigned
- Nov 15, 2006
- Organization subpart
- No
Authorized official
- Name
- Dr. Craig Randall Belk, OD.
- Title
- Owner
- Phone
- (228) 832-1832
Practitioners 4
-
Craig R Belk, OD
-
Brian L Hunt, O.D.
-
Nha Ngo, OD
-
Paul M Williston, O.C.
Laboratory certificates & supplier records
Medicare medical equipment & supply locations
| Supplier | Supplies | Medicare assignment |
|---|---|---|
| Belk Eye Clinic |
Prosthetic Lenses: Conventional Eyeglasses|Prosthetic Lenses: Conventional Contact Lenses | Accepts assignment |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in MS
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20061219000020 | MS | Part B Supplier - Clinic/Group Practice | 4981603024 |
Receives reassigned benefits from 4 practitioners Practice locations: Gulfport, MS |
| O20100930002771 | MS | DME Supplier - Physician - Optometrist | 4981603024 | Practice locations: Gulfport, MS |
National Provider Directory
Locations
12199 Highway 49
Ste 100
Gulfport, MS 39503
Phone (228) 832-1832
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist |
152W00000X | 573 | MS | Yes |
Addresses
Primary practice location
12199 Highway 49 Ste 100
Gulfport, MS 39503-3167
Mailing address
12199 Highway 49 Ste 100
Gulfport, MS 39503-3167
Phone (228) 832-1832
Other providers in Gulfport, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 31, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.