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FAYETTEVILLE EYECARE CLINIC
NPI 1588999767
Optometrist in Fayetteville, AR

Active since October 06, 2009CLIA 04D2002024 · Waiver
1915 N GREEN ACRES RD, FAYETTEVILLE, AR 72703(479) 442-8961(479) 442-6440 Get Directions Write a Review

NPPES record last updated: June 24, 2020. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Fayetteville Eyecare Clinic NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

FAYETTEVILLE EYECARE CLINIC (NPI 1588999767) is a healthcare organization registered as an optometrist in Fayetteville, Arkansas and active in the NPI registry since October 2009. The organization holds a CLIA Waiver certificate valid through January 5, 2028 and lists Tasker N Rodman, Managing Partner, as its authorized official.

NPPES Registry Identity

NPI1588999767
Entity TypeOrganization
Primary Taxonomy152W00000X
Legal Business NameFAYETTEVILLE EYECARE CLINIC
Location Address1915 N GREEN ACRES RDFayetteville, AR 72703-2617
Mailing Address11225 Huron Ln Ste 200aLittle Rock, AR 72211-1861 · (479) 442-8961 · Fax (479) 442-6440
Phone(479) 442-8961
Fax(479) 442-6440
Organization SubpartNo
Authorized OfficialTasker N RodmanManaging Partner · (501) 225-9944
Enumeration DateOctober 6, 2009
Last NPPES UpdateJune 24, 2020
NPPES CertifiedJune 24, 2020
✔ NPI 1588999767 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOptometristEye and Vision Services Providers
Taxonomy Code152W00000X
Definition
Doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system.
1915 N GREEN ACRES RD, Fayetteville, AR 72703
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Other Identifiers 1

Medicaid182431722AR

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arkansas Health & Wellness, Ambetter from Home State Health, Ambetter from Louisiana Healthcare Connections and more.Insurance ›

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 04D2002024

Fayetteville Eyecare Clinic · Fayetteville, AR
Active · expires Jan 5, 2028
CLIA Number04D2002024
Laboratory TypePhysician Office
Certificate Effective DateJanuary 6, 2026
Certificate Expiration DateJanuary 5, 2028
Laboratory DirectorTerri Herman
Laboratory Phone(501) 225-9944
Laboratory LocationFayetteville Eyecare Clinic1915 North Green Acres Road, Fayetteville, AR 72703
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MRS. NICOL R NEAL SLP
Speech-Language Pathologist
1915 N GREEN ACRES RD
FAYETTEVILLE, AR 72703
Washington County (479) 521-6060
DR. JOHN R VANDERBUSH O.D.
Optometrist
1915 N GREEN ACRES RD
FAYETTEVILLE, AR 72703
Washington County (479) 442-8961

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Fayetteville Eyecare Clinic's NPI number?

The NPI number for Fayetteville Eyecare Clinic is 1588999767. It was assigned to this organization in the NPPES registry on October 6, 2009.

Where is Fayetteville Eyecare Clinic located?

Fayetteville Eyecare Clinic is located at 1915 N Green Acres Rd, Fayetteville, AR 72703. The listed phone number is (479) 442-8961.

What is Fayetteville Eyecare Clinic's specialty?

The primary specialty registered for this NPI is Optometrist with taxonomy code 152W00000X.

Does Fayetteville Eyecare Clinic hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 04D2002024) is associated with this NPI, valid through January 5, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Fayetteville Eyecare Clinic accept?

Health plans from Ambetter from Arkansas Health & Wellness, Ambetter from Home State Health, Ambetter from Louisiana Healthcare Connections, Ambetter from Magnolia Health and Ambetter from Superior HealthPlan and 4 other insurers list Fayetteville Eyecare Clinic as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Fayetteville Eyecare Clinic was last updated on June 24, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.