PREMIER EYE CLINIC, P. A.
Complete NPI Record 1982898219
Clinic/Center in Port Orange, FL
Active since August 29, 2007
Complete NPI Dataset
This page contains the complete raw NPPES record for Premier Eye Clinic, P. A. (NPI 1982898219), a clinic/center organization in Port Orange, FL. All 34 fields on file are listed with their current values and official NPPES definitions, exactly as recorded in the National Plan and Provider Enumeration System. Only fields that contain data are included, so the number of fields shown varies from one NPI record to another.
Use the tools below to filter fields by category, search within the record, or jump straight to a specific field. You can download the full record as a CSV, JSON, or text file, or filter first and export only the fields you need. The Print Clean Summary button produces a printer-friendly copy of the record.
Registry File Document Utilities
- NPI: 1982898219 Field 1/34
- The 10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider. The NPI number includes an ISO standard check-digit in the 10th position. There is no intelligence about the health care provider in the number.
- Entity Type Code: 2 Field 2/34
- Code describing the type of health care provider that is being assigned an NPI. 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 (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
- Employer Identification Number EIN: Not available Field 3/34
- The Employer Identification Number (EIN), assigned by the IRS, of the provider being identified.
- Provider Organization Name Legal Business Name: QING GE Field 4/34
- The name of the organization provider. If the provider is an organization, this is the legal business name.
- Provider Other Organization Name: PREMIER EYE CLINIC, P. A. Field 5/34
- Other name by which the organization provider is or has been known.
- Provider Other Organization Name Type Code: 3 Field 6/34
- Code identifying the type of other 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 First Line Business Mailing Address: 1515 HERBERT ST Field 7/34
- The first line mailing address of the provider being identified. This data element may contain the same information as "Provider first line location address".
- Provider Second Line Business Mailing Address: SUITE 208 Field 8/34
- The second line mailing address of the provider being identified. This data element may contain the same information as "Provider second line location address".
- Provider Business Mailing Address City Name: PORT ORANGE Field 9/34
- The city name in the mailing address of the provider being identified.
- Provider Business Mailing Address State Name: FL Field 10/34
- The State or Province name in the mailing address of the provider being identified. This data element may contain the same information as "Provider location address State name".
- Provider Business Mailing Address Postal Code: 321296104 Field 11/34
- The postal ZIP or zone code in the mailing address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available. This data element may contain the same information as "Provider location address postal code".
- Provider Business Mailing Address Country Code If outside U S : US Field 12/34
- The country code in the mailing address of the provider being identified. This data element may contain the same information as "Provider location address country code".
- Provider Business Mailing Address Telephone Number: 3867886198 Field 13/34
- The telephone number associated with mailing address of the provider being identified. This data element may contain the same information as "Provider location address telephone number".
- Provider Business Mailing Address Fax Number: 3867884616 Field 14/34
- The fax number associated with the mailing address of the provider being identified. This data element may contain the same information as "Provider location address fax number".
- Provider First Line Business Practice Location Address: 1515 HERBERT ST Field 15/34
- The first line 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 Second Line Business Practice Location Address: SUITE 208 Field 16/34
- The second line 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 Business Practice Location Address City Name: PORT ORANGE Field 17/34
- The city name in the location address of the provider being identified.
- Provider Business Practice Location Address State Name: FL Field 18/34
- The State code in the location of the provider being identified.
- Provider Business Practice Location Address Postal Code: 321296104 Field 19/34
- The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
- Provider Business Practice Location Address Country Code If outside U S : US Field 20/34
- The country code in the location address of the provider being identified.
- Provider Business Practice Location Address Telephone Number: 3867886198 Field 21/34
- The telephone number associated with the location address of the provider being identified.
- Provider Business Practice Location Address Fax Number: 3867884616 Field 22/34
- The fax number associated with the location address of the provider being identified.
- Authorized Official Last Name: GE Field 25/34
- The last name of the person authorized to submit the NPI application or to change NPS data for a health care provider.
- Authorized Official First Name: QING Field 26/34
- The first name of the authorized official.
- Authorized Official Title or Position: OWNER/DIRECTOR Field 27/34
- The title or position of the authorized official.
- Authorized Official Telephone Number: 3867886198 Field 28/34
- The 10-position telephone number of the authorized official.
- Healthcare Provider Taxonomy Code 1: 261Q00000X Field 29/34
- This field represents the provider's taxonomy code, which classifies their type, classification, and area of specialization. This code comes from the Healthcare Provider Taxonomy Code Set maintained by the National Uniform Claim Committee (NUCC). The NPS will associate these data with the license data for providers with Entity type code = 1.
- Provider License Number 1: ME 96155 Field 30/34
- The license number issued to the provider being identified. The NPS can accommodate multiple license numbers for multiple specialties and for multiple States. The NPS will associate this data element with "provider taxonomy code".
- Provider License Number State Code 1: FL Field 31/34
- The two-letter state code representing the U.S. state or territory that issued the provider's license. This field is linked to the Provider License Number field and identifies the jurisdiction where that license is valid. A provider may have multiple state codes if they hold licenses in more than one state.
- Healthcare Provider Primary Taxonomy Switch 1: Y Field 32/34
- This field shows whether the related taxonomy code is the provider's primary specialty. It is a single-character value: "Y" indicates the taxonomy is the primary one, while "N" indicates it is not. Each provider record can have only one taxonomy code marked as primary.
- Is Organization Subpart: N Field 33/34
- Indicates whether the provider is a subpart of a larger organization. This is a single-character code: "Y" means the entity is an organizational subpart, while "N" means it is not. Subparts typically include hospital departments, clinics, or other distinct units that fall under a parent organization.
- Authorized Official Credential Text: M.D., PH.D. Field 34/34
- The professional credential(s) of the authorized official listed on the provider's NPI record. Examples include MD (Doctor of Medicine), DO (Doctor of Osteopathy), RN (Registered Nurse), DDS (Doctor of Dental Surgery), PhD, or other recognized designations that reflect the official's qualifications.
Other Provider Identifiers 1
Legacy and payer-issued identifiers reported to the NPPES registry for this provider.
I71676 Medicare UPIN
Identifier 1/1State: FL
Medicare UPIN (Unique Physician Identification Number): A legacy six-character alphanumeric identifier previously issued by Medicare to individual physicians before being retired and replaced by the NPI system.
Medicare UPIN (Unique Physician Identification Number): A legacy six-character alphanumeric identifier previously issued by Medicare to individual physicians before being retired and replaced by the NPI system.
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