NPIMap

Organization Active NPI

Phillips Eye Care, Inc.

  • Optometrist
  • Meridian, MS
National Provider Identifier
1992025951
Registry record updated Nov 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
799 Issued in MS
Legal business name
PHILLIPS EYE CARE, INC.
Practice address
4803 Poplar Springs Dr Ste a
Meridian, MS 39305-2691
Phone
(601) 693-0176
Fax
(601) 693-0177
NPI assigned
Jun 1, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 13, 2024

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

Authorized official

Name
Dr. Tracy B Phillips, O.D.NPI 1508013293
Title
Owner
Phone
(601) 693-0176

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 799 MS Primary

Addresses

Primary practice location

4803 Poplar Springs Dr Ste a
Meridian, MS 39305-2691

Mailing address

106 Macy Dr
Philadelphia, MS 39350-3792

Other practice location 1

576 E Main St
Philadelphia, MS 39350-2841
Phone (601) 568-2020

Other names 1

  • Bright Eyes Family Eye Care Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20101102001035 MS Part B Supplier - Clinic/Group Practice 2365636412 Receives reassigned benefits from 1 practitioner
Practice locations: Philadelphia, MS; Meridian, MS

National Provider Directory

National Provider Directory

Locations

4803 Poplar Springs Dr
Ste A
Meridian, MS 39305
Phone (601) 693-0176

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": "1275350400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1731456000000",
    "number": "1992025951",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "106 MACY DR",
            "city": "PHILADELPHIA",
            "state": "MS",
            "postal_code": "393503792"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4803 POPLAR SPRINGS DR STE A",
            "city": "MERIDIAN",
            "state": "MS",
            "postal_code": "393052691",
            "telephone_number": "601-693-0176",
            "fax_number": "601-693-0177"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "576 E Main St",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "MS",
            "postal_code": "393502841",
            "country_code": "US",
            "telephone_number": "601-568-2020",
            "fax_number": "601-568-4553",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "PHILLIPS EYE CARE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-06-01",
        "last_updated": "2024-11-13",
        "certification_date": "2024-11-13",
        "status": "A",
        "authorized_official_last_name": "PHILLIPS",
        "authorized_official_first_name": "TRACY",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "601-693-0176",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "MS",
            "license": "799",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bright Eyes Family Eye Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Meridian, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2024; 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.