NPIMap

Organization Active NPI

SS Eye Group, PLLC

Doing business as Teague Eye & Vision Clinic

  • Optometrist
  • Little Rock, AR
National Provider Identifier
1992232102
Registry record updated Aug 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
SS EYE GROUP, PLLC
Doing business as
Teague Eye & Vision Clinic
Practice address
11115 Hermitage Rd
Little Rock, AR 72211-3807
Phone
(501) 224-7056
Fax
(501) 224-4327
NPI assigned
May 18, 2017
Last updated
Aug 13, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2024

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

Authorized official

Name
Russell SimmonsNPI 1720016272
Title
Owner
Phone
(501) 778-2363

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
Optometrist 152W00000X NU Primary

Addresses

Primary practice location

11115 Hermitage Rd
Little Rock, AR 72211-3807

Mailing address

113 W Carpenter St
Benton, AR 72015-3317
Phone (501) 778-2363

Other names 1

  • Teague Eye & Vision Clinic Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170905000507 AR Part B Supplier - Clinic/Group Practice 4486927035 Receives reassigned benefits from 4 practitioners
Practice locations: Little Rock, AR

National Provider Directory

National Provider Directory

Locations

113 W Carpenter St
Benton, AR 72015
Phone (501) 778-2363

Practitioners & affiliated clinicians

Practitioners 9

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1495065600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1723507200000",
    "number": "1992232102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "113 W CARPENTER ST",
            "city": "BENTON",
            "state": "AR",
            "postal_code": "720153317",
            "telephone_number": "501-778-2363",
            "fax_number": "501-778-5329"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11115 HERMITAGE RD",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722113807",
            "telephone_number": "501-224-7056",
            "fax_number": "501-224-4327"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SS EYE GROUP, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-05-18",
        "last_updated": "2024-08-13",
        "certification_date": "2024-08-13",
        "status": "A",
        "authorized_official_last_name": "SIMMONS",
        "authorized_official_first_name": "RUSSELL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "501-778-2363"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Teague Eye & Vision Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Little Rock, AR

Sources for this page

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