JFJ EYECARE, LTD (ILLINOIS EYE SURGEONS) - NPI NUMBER 1376586685

Summary

Provider Name: JFJ EYECARE, LTD (ILLINOIS EYE SURGEONS)

NPI Number: 1376586685

Clasification: Optometrist (152W00000X)

Address:
3990 N ILLINOIS ST
SWANSEA, IL
ZIP 62226

Phone Number: (618) 277-1130



Detailed Information

JFJ EYECARE, LTD is an optometrist in Swansea, IL. The provider is 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. The assigned NPI number for this provider is 1376586685 and is registered as an organization entity type and is a single specialty group.
The provider Other Name Is Illinois Eye Surgeons.

The provider's business address is:

3990 N ILLINOIS ST
SWANSEA, IL
ZIP 62226
Phone: (618) 277-1130
Fax: (618) 277-6651

The provider's authorized official is Bart Aaron Jones .
The authorized official title is Owner and has the following contact phone number (618) 277-1130.

The enumeration date for this NPI number is 6/14/2006 and was last updated on 5/15/2012.

Map - Location of Practice

Taxonomy Codes

The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1 152W00000X Optometrist Yes

Other (Legacy) Identifiers

The following legacy identifiers are available for this provider:

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1 554480 MEDICARE PIN IL
2 CF8690 MEDICARE PIN IL
3 CF8691 MEDICARE PIN IL
4 CH6508 MEDICARE PIN IL
5 211586 MEDICARE PIN
6 291990 MEDICARE PIN IL
7 554490 MEDICARE PIN IL

NPI Record

No. Field Name Field Value Field Definition 1
1 NPI 1376586685 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.
2 Entity Type Code 2 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).
3 Employer Identification Number EIN The Employer Identification Number (EIN), assigned by the IRS, of the provider being identified.
4 Provider Organization Name Legal Business Name JFJ EYECARE, LTD The name of the organization provider. If the provider is an organization, this is the legal business name.
5 Provider Other Organization Name ILLINOIS EYE SURGEONS Other name by which the organization provider is or has been known.
6 Provider Other Organization Name Type Code 5 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.
7 Provider First Line Business Practice Location Address 3990 N ILLINOIS ST 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.
8 Provider Business Practice Location Address City Name SWANSEA The city name in the location address of the provider being identified.
9 Provider Business Practice Location Address State Name IL The State code in the location of the provider being identified.
10 Provider Business Practice Location Address Postal Code 62226 The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
11 Provider Business Practice Location Address Country Code If outside U S US The country code in the location address of the provider being identified.
12 Provider Business Practice Location Address Telephone Number 6182771130 The telephone number associated with the location address of the provider being identified.
13 Provider Business Practice Location Address Fax Number 6182776651 The fax number associated with the location address of the provider being identified.
14 Provider Enumeration Date 6/14/2006 The date the provider was assigned a unique identifier (assigned an NPI).
15 Last Update Date 5/15/2012 The date that a record was last updated or changed.
16 Authorized Official Last Name JONES The last name of the person authorized to submit the NPI application or to change NPS data for a health care provider.
17 Authorized Official First Name BART The first name of the authorized official.
18 Authorized Official Middle Name AARON The middle name of the authorized official.
19 Authorized Official Title or Position OWNER The title or position of the authorized official.
20 Authorized Official Telephone Number 6182771130 The 10-position telephone number of the authorized official.
21 Healthcare Provider Taxonomy Code 1 152W00000X Code designating the provider type, classification, and specialization. Codes are from the Healthcare Provider Taxonomy code list. The NPS will associate these data with the license data for providers with Entity type code = 1.
22 Healthcare Provider Primary Taxonomy Switch 1 Y
23 Other Provider Identifier 1 554480 Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
24 Other Provider Identifier Type Code 1 08 Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
25 Other Provider Identifier State 1 IL
26 Other Provider Identifier 2 CF8690 Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
27 Other Provider Identifier Type Code 2 08 Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
28 Other Provider Identifier State 2 IL
29 Other Provider Identifier 3 CF8691 Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
30 Other Provider Identifier Type Code 3 08 Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
31 Other Provider Identifier State 3 IL
32 Other Provider Identifier 4 CH6508 Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
33 Other Provider Identifier Type Code 4 08 Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
34 Other Provider Identifier State 4 IL
35 Other Provider Identifier 5 211586 Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
36 Other Provider Identifier Type Code 5 08 Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
37 Other Provider Identifier 6 291990 Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
38 Other Provider Identifier Type Code 6 08 Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
39 Other Provider Identifier State 6 IL
40 Other Provider Identifier 7 554490 Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
41 Other Provider Identifier Type Code 7 08 Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
42 Other Provider Identifier State 7 IL
43 Is Organization Subpart N
44 Authorized Official Credential Text MD
45 Healthcare Provider Taxonomy Group 1 193400000X SINGLE SPECIALTY GROUP

Similar Providers Nearby

NPI Provider Name NPI Type Taxonomy
1083897706 MICHAEL MURPHY, OD VISION CARE ASSOCIATES, LTD Organization Optometrist
1124208566 DR. ERIC A OWENS, O.D. Individual Optometrist
1124214051 3F VISION LCC Organization Optometrist
1205025095 DAVID B. HARTIG O.D. LLC Organization Optometrist
1215335385 EYECARE MANAGEMENT, LLC Organization Optometrist
1265527394 PERFORMANCE EYECARE PC Organization Optometrist
1295778587 EYECARE MANAGEMENT LLC Organization Optometrist
1306076518 DR. DAVID D ERNST, O.D. Individual Optometrist
1316091887 MR. TROY W JOHNSON, OD Individual Optometrist
1326150822 JOHN BUSH, OD Individual Optometrist
1467423566 DR. GEORGE MICHAEL MURPHY, O.D. Individual Optometrist
1487643540 DR. THOMAS ERROL KRAEMER, OD Individual Optometrist


Download NPI Record

Download this NPI record in Text format: Export

Download this NPI record in Excel (CSV) format: Export

Download this NPI record in XML format: Export




This page was last updated on: 4/19/2015

(1) Field Definition Source-. Federal Register / Vol. 69, No. 15 / Friday, January 23, 2004 / Rules and Regulations - Part II Department of Health and Human Services Office of the Secretary 45 CFR Part 162 HIPAA Administrative Simplification: Standard Unique Health Identifier for Health Care Providers; Final Rule

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.