NPIMap

Organization Active NPI

Rose Eye Clinic

  • Optometrist
  • Indianola, MS
National Provider Identifier
1992966204
Registry record updated Aug 10, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
571 Issued in MS
Legal business name
ROSE EYE CLINIC
Practice address
401 Catchings Ave
Indianola, MS 38751-2468
Phone
(662) 887-5668
Fax
(662) 887-5671
NPI assigned
Jun 19, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 10, 2011

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

Authorized official

Name
Dr. Walter Samuel Rose, OD
Title
Owner
Phone
(662) 887-5668

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 571 MS Primary

Addresses

Primary practice location

401 Catchings Ave
Indianola, MS 38751-2468

Mailing address

401 Catchings Ave
Indianola, MS 38751-2468
Phone (662) 887-5668

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1213833600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1312934400000",
    "number": "1992966204",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 CATCHINGS AVE",
            "city": "INDIANOLA",
            "state": "MS",
            "postal_code": "387512468",
            "telephone_number": "662-887-5668",
            "fax_number": "662-887-5671"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 CATCHINGS AVE",
            "city": "INDIANOLA",
            "state": "MS",
            "postal_code": "387512468",
            "telephone_number": "662-887-5668",
            "fax_number": "662-887-5671"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROSE EYE CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-19",
        "last_updated": "2011-08-10",
        "status": "A",
        "authorized_official_last_name": "ROSE",
        "authorized_official_first_name": "WALTER",
        "authorized_official_middle_name": "SAMUEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "662-887-5668",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "MS",
            "license": "571",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianola, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2011; 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.