JOHN B WITHERSPOON OPTOMETRIC PHYSICIAN LTD (NPI# 1700194990) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1700194990 |
| Entity Type | Organization |
| Organization Name | JOHN B WITHERSPOON OPTOMETRIC PHYSICIAN LTD |
| Other Organization Name | CONWAY EYE CENTER |
| Practice Address |
29 River Road Dr E Mayflower AR 72106-8409 |
| Mailing Address |
1155 Hwy 65 North Conway AR 72032 |
| Practice Telephone | 5013289500 |
| Practice Fax Number | 5013285148 |
| Mailing Telephone | 5013289500 |
| Mailing Fax Number | 5013285148 |
| Enumeration Date | 2010-09-22 |
| Last Update Date | 2010-10-27 |
| Authorized Official Name | DR. JOHN B WITHERSPOON (OWNER/PHYSICIAN) |
| Authorized Official Telephone | 5013289500 |
| Authorized Official Credential | O.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 152W00000X | Optometrist | 2272 | AR | Eye and Vision Services Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AR | 106399722 | 05 | |
| AR | MEDICARE PTAN | 5G617 | 01 |
| Other Name | Type Code |
|---|---|
| Conway Eye Center | Doing Business As Name - Organization |
| Street Address |
29 RIVER ROAD DR E |
| City | MAYFLOWER |
| State | AR |
| Zip Code | 72106-8409 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790306124 | Jbr Enterprises Inc | Pharmacy | 600 Hwy 365, Mayflower, AR 72106 | 2020-04-27 |
| 1285903955 | Melissa Wallace | Physical Therapist | 582 Hwy 365 Ste 3, Mayflower, AR 72106 | 2011-12-23 |
| 1790053502 | Freds Stores of Tennessee Inc. | Pharmacy | 652 Hwy 365, Mayflower, AR 72106 | 2011-12-07 |
| 1922136746 | My House, Inc. | Case Management | #760 Highway 365 South, Mayflower, AR 72106 | 2007-03-01 |
| 1407914583 | Mayflower School | Local Education Agency (LEA) | 18 Eagle Cir., Mayflower, AR 72106 | 2006-12-04 |
| 1407890577 | Erin R. Lewis | Physical Therapist | 4 Grove Street, Mayflower, AR 72106 | 2006-06-16 |
| 1790867257 | Mayflower Family Medicine | Clinic/Center | 587 Highway 365, Mayflower, AR 72106 | 2006-10-20 |
| 1033219753 | Shelly M Clifton | Nurse Practitioner | 587 Highway 365, Mayflower, AR 72106 | 2006-09-23 |
| 1902235302 | Jami Lynn Faulkner | Dietitian, Registered | 6 Ledrick Cir, Mayflower, AR 72106-8404 | 2013-11-06 |
| 1780912444 | Margaret M Healy | Social Worker | 50 River Bend Rd, Mayflower, AR 72106-8415 | 2009-11-18 |
| Find all providers in zip 72106 | ||||
| Taxonomy Code | 152W00000X |
| Grouping | Eye and Vision Services Providers |
| Classification | Optometrist |
| 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. |
| Notes: Source: American Optometric Association (AOA), approved by the AOA’s Board of Trustees, June 21, 2005. [7/1/2006: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497373088 | Taylor Renz | Optometrist | 1225 W Beebe Capps Expy, Searcy, AR 72143-5179 | 2020-07-09 |
| 1932733185 | Ashley Mcgee | Optometrist | 723 Falls Blvd S Ste A, Wynne, AR 72396-3509 | 2020-02-26 |
| 1972144566 | Randy Bell Od Pllc | Optometrist | 101 W Walnut St, Rogers, AR 72756-6662 | 2019-10-04 |
| 1881241792 | Radiant Eye Care Optometric Corporation | Optometrist | 1210 Jtl Pkwy E Ste 103, Springdale, AR 72762-7019 | 2019-08-25 |
| 1457905903 | Heather Snyder | Optometrist | 1021 South Waldron Road, Fort Smith, AR 72903 | 2019-08-01 |
| 1568024230 | Lawrence Allen King IIi | Optometrist | 4300 Rogers Ave Ste 46, Fort Smith, AR 72903-3152 | 2019-07-02 |
| 1306406269 | Idell Marie Mitchell | Optometrist | Eye Clinic, 1100 N College Ave, Fayetteville, AR 72703 | 2019-06-13 |
| 1417413717 | Med Southwest, Pllc | Optometrist | 114 E 49th St, Texarkana, AR 71854-2117 | 2019-02-12 |
| 1588120877 | Med Southwest, Pllc | Optometrist | 2510 N Hervey St, Hope, AR 71801-8419 | 2019-02-12 |
| 1093279275 | Piper's Vision Xpress, LLC | Optometrist | 50 Paul Wood Lane, Mountian Home, AR 72653 | 2019-01-22 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.