Lights Prosthetic Eyes Inc

Primary specialty

OcularistTaxonomy code 156FX1700X

License

203000116 Issued in IL

Legal business name

LIGHTS PROSTHETIC EYES INC

Practice address

1318 W Candletree Dr
Ste 3
Peoria, IL 61614-8509

Phone

(309) 676-3663

Fax

(309) 676-0359

NPI assigned

May 30, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Randy L Light, B.C.O., B.A.D.O.NPI 1124060074

Title

President

Phone

(309) 676-3663

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

• Lights Prosthetic Eyes Inc

  • Ocularist
  • Springfield, MO
  • NPI 1487817193

  3577684943

  Same PAC ID

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

Tax ID family

Lights Prosthetic Eyes Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Lights Prosthetic Eyes Inc

  • Ocularist
  • Springfield, MO
  • NPI 1487817193
  NPD tax ID

Practitioners 2

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

• Randy L Light, B.C.O., B.A.D.O.

  • Ocularist
  • Peoria, IL
  • NPI 1124060074
  NPD (past) Authorized official
• Benjamin Leroy Light, OCULARIST APPRENTICE

  • Ocularist
  • Peoria, IL
  • NPI 1447294483
  NPD (past)

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

{
    "created_epoch": "1148947200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1246579200000",
    "number": "1972550390",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1318 W CANDLETREE DR",
            "address_2": "STE 3",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616148509",
            "telephone_number": "309-676-3663",
            "fax_number": "309-676-0359"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1318 W CANDLETREE DR",
            "address_2": "STE 3",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616148509",
            "telephone_number": "309-676-3663",
            "fax_number": "309-676-0359"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIGHTS PROSTHETIC EYES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-30",
        "last_updated": "2009-07-03",
        "status": "A",
        "authorized_official_last_name": "LIGHT",
        "authorized_official_first_name": "RANDY",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "309-676-3663",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "B.C.O., B.A.D.O."
    },
    "taxonomies": [
        {
            "code": "156FX1700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Technician/Technologist, Ocularist",
            "state": "IL",
            "license": "203000116",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jacquelyn M Liggett, SLP
• Amy M. Light, LCPC
• Benjamin Leroy Light, OCULARIST APPRENTICE
• Jennifer Marie Light, M.D.
• Randy L Light, B.C.O., B.A.D.O.
• Maureen A Lillich, M.D.
• Hyung Jin Lim, DO
• Lilian Elizabeth Atanacio Lim, MD
• Limestone Walters CCS Dist 316
• Julian Jwchun Lin, MD

• Technician/Technologist in Peoria, IL
• Providers in Peoria, IL by specialty
• Technician/Technologist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.