OZARK EYE CENTER OF HIGHLAND (PROGRESSIVE EYE CENTER INC) NPI 1649397126

Optometrist in Cherokee Village, AR

NPI 1649397126 Organization Optometrist Medicare Supplier Accepts Medicare Approved Payment CLIA Number 04D1094327 CLIA Certificate of Waiver

About OZARK EYE CENTER OF HIGHLAND (PROGRESSIVE EYE CENTER INC)

Ozark Eye Center Of Highland (progressive Eye Center Inc) is a provider established in Cherokee Village, Arkansas specializing in optometrist. The NPI number of Ozark Eye Center Of Highland (progressive Eye Center Inc) is 1649397126 and was assigned on March 2007. The practitioner's primary taxonomy code is 152W00000X with license number AR2408 (AR). The provider is registered as an organization and their NPI record was last updated 11 years ago. Ozark Eye Center Of Highland (progressive Eye Center Inc) operates as a single speciality business group with one or more individual providers who practice the same area of specialization. The provider's former legal business name is Ozark Eye Center Of Highland. The authorized official of this NPI record is Jerry H Ellis O.d. (President)

Ozark Eye Center Of Highland is a medicare supplier with PTAN 1101810001 who accepts Medicare assignment for all durable medical equipment and supplies. The provider accepts the Medicare allowable as payment in full.The supplier carries the following product categories: Prosthetic Lenses: Conventional Contact Lenses or Prosthetic Lenses: Conventional Eyeglasses.

The CLIA number of Ozark Eye Center Of Highland is 04D1094327 registered as a "physician office" facility with a CLIA Certificate of Waiver. This CLIA certificate is issued to Ozark Eye Center Of Highland to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.

NPI

1649397126

Provider NameOZARK EYE CENTER OF HIGHLAND (PROGRESSIVE EYE CENTER INC)
Provider Location Address197 HOSPITAL DRIVE SUITE A CHEROKEE VILLAGE, AR 72529
Provider Mailing Address197 HOSPITAL DRIVE SUITE A CHEROKEE VILLAGE, AR 72529
NPI Entity TypeOrganization
Is Sole Proprietor?N/A
Is Organization Subpart?No
Other Organization NameOZARK EYE CENTER OF HIGHLAND
Other Name TypeFormer Legal Business Name (4)
Enumeration Date03-22-2007
Last Update Date10-12-2010


Primary Taxonomy

Taxonomy Code152W00000X
ClassificationOptometrist
TypeEye and Vision Services Providers
License No.AR2408
License StateAR
Taxonomy DescriptionDoctors 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.

Business Address

OZARK EYE CENTER OF HIGHLAND
197 HOSPITAL DRIVE
SUITE A
CHEROKEE VILLAGE, AR
ZIP 72529
Phone: (870) 257-2100
Fax: (870) 257-4395

Get Directions


Mailing Address

OZARK EYE CENTER OF HIGHLAND
197 HOSPITAL DRIVE
SUITE A
CHEROKEE VILLAGE, AR
ZIP 72529
Phone: (870) 257-2100
Fax: (870) 257-4395



Authorized Official

Authorized Official Name JERRY H ELLIS O.D.
Authorized Official TitlePRESIDENT
Authorized Official Phone(870) 257-2100

Medical Equipment Supplier

The provider carries the following medical supplies product categories:

PTAN1101810001
Accepts Medicare AssignmentYES
Specialities ListOptician, Optometrist.
Supplies List
  • Prosthetic Lenses: Conventional Contact Lenses - Conventional Contact Lenses
  • Prosthetic Lenses: Conventional Eyeglasses - Conventional Eyeglasses
Competitive BiddingNO

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for the NPI number 1649397126 is:

CLIA Number04D1094327
Facility TypePHYSICIAN OFFICE
Certificate TypeCertificate of Waiver

Group Taxonomy


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

Secondary Taxonomies


The secondary taxonomy codes define the provider type, classification, and specialization. For individual NPIs the license data is associated to each taxonomy code.

No. Taxonomy Code Type Classification Specialization License No. State Primary
1152W00000XEye and Vision Services ProvidersOptometrist2408ARNo

Taxonomy Description: 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.

Additional Identifiers


Additional identifier(s) currently or formerly used as an identifier for the provider. The codes may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State
128855722MEDICAID (05)AR
1101810001MEDICARE NSC (07)AR
123535722MEDICAID (05)AR
5B794MEDICARE ID-TYPE UNSPECIFIED (04)AR

Other Providers at the same location


The following provider is registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1083776611DR. JERRY H ELLIS OD
Individual
Optometrist197 HOSPITAL DRIVE SUITE A
CHEROKEE VILLAGE, AR 72529
(870) 257-2100

NPI Footnotes

What is the National Provider Indentifier (NPI)?
The NPI is 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.

Provider Location Address
The location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.

Provider Mailing Address
The mailing address of the provider being identified. This address may contain the same information as the provider location address.

Entity Type Code
The code describing the type of health care provider that is being assigned an NPI.
The entity type codes are:
1 = Person: individual human being who furnishes health care;
2 = Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)

What is a Subpart?
Subparts are the components and separate physical locations of organization health care providers. Subpart examples include:
Hospital components include outpatient departments, surgical centers, psychiatric units, and laboratories. These components are often separately licensed or certified by States and may exist at physical locations other than that of the hospital of which they are a component.

Provider Other Organization Name
The other organization name is the alternative last name by which the provider is or has been known (if an individual) or other name by which the organization provider is or has been known. The code identifying the type of other name. The provider other organization name codes are:
1 = former name;
2 = professional name;
3 = doing business as (d/b/ a) name;
4 = former legal business name; :
5 = other.

Provider Enumeration Date
The date the provider was assigned a unique identifier (assigned an NPI).

Last Update Date
The date that a NPI record was last updated or changed.

Primary Taxonomy Code
The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Authorized Official Name
The name of the person authorized to submit the NPI application or to officially change data for a health care provider.