MR. CHARLES E BEDFORD (NPI# 1760401202) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1760401202 |
| Entity Type | Individual |
| Full Name | MR. CHARLES E BEDFORD |
| Credential | O.D. |
| Practice Address |
1270 S Jasper St Decatur IL 62521-3531 |
| Practice Telephone | 2174228032 |
| Mailing Telephone | 2174228032 |
| Enumeration Date | 2006-07-18 |
| Last Update Date | 2014-11-18 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 152W00000X | Optometrist | 467080 | IL | Eye and Vision Services Providers |
| N | 152WC0802X |
Optometrist Specialization: Corneal and Contact Management |
467080 | IL | Eye and Vision Services Providers |
| N | 152WX0102X |
Optometrist Specialization: Occupational Vision |
467080 | IL | Eye and Vision Services Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | RAILROAD MEDICARE | 410017583 | 01 |
| IL | 046007080 | 05 | |
| IL | DME MEDICARE | 6527140002 | 01 |
| IL | BLUE CROSS AND SHIELD | 0005884011 | 01 |
| Street Address |
1270 S JASPER ST |
| City | DECATUR |
| State | IL |
| Zip Code | 62521-3531 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053572255 | Decatur Eyecare Associates | Optometrist | 1270 S Jasper St, Decatur, IL 62521-3531 | 2008-06-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053927988 | Caleb David Braasch | Pharmacist | 1818 South Airport Rd, Decatur, IL 62521 | 2020-09-16 |
| 1295390490 | Crossing Recovery Center | Substance Abuse Rehabilitation Facility | Crossing Recovery Center, 495 East Central Ave, Decatur, IL 62521 | 2019-05-03 |
| 1396300638 | Crossing Recovery Center | Substance Abuse Rehabilitation Facility | 495 E Central Ave, Decatur, IL 62521 | 2019-05-02 |
| 1679138911 | Crossing Recovery Center | Substance Abuse Rehabilitation Facility | 495 East Central Ave, Decatur, IL 62521 | 2019-05-02 |
| 1154848034 | Zack Shaw | Physical Therapist | 4855-57 East 36, Decatur, IL 62521 | 2017-08-23 |
| 1790032852 | Prashant Morolia | Family Medicine | 4775 E Maryland St, Decatur, IL 62521 | 2012-08-08 |
| 1003188913 | Evergreen Place Decatur, LLC | Assisted Living Facility | 4825 E Evergreen Court, Decatur, IL 62521 | 2012-02-08 |
| 1104133099 | Suzette Marie Shafer | Occupational Therapy Assistant | 1790 S. Fairview Ave., Decatur, IL 62521 | 2010-09-13 |
| 1467784090 | Community Health Improvement Center | Clinic/Center | 1221 East Condit Street, Decatur, IL 62521 | 2010-02-08 |
| 1982839056 | Kelly Clark Dds PC | Dentist | 3737 Us Rt 36 E, Decatur, IL 62521 | 2009-05-19 |
| Find all providers in zip 62521 | ||||
| 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 |
|---|---|---|---|---|
| 1295340172 | National Vision Inc | Optometrist | 1107 Beltline Rd Se Ste C, Decatur, AL 35601-6556 | 2020-09-09 |
| 1902433691 | Decatur Eye Care | Optometrist | 321 W Hill St Ste 6, Decatur, GA 30030-4362 | 2020-03-24 |
| 1114468089 | T&t Eyecare, LLC | Optometrist | 2570 Blackmon Dr., Suite 360, Decatur, GA 30033 | 2017-03-13 |
| 1487952503 | Michael A. Harshman P.C. | Optometrist | 815 S 13th St, Decatur, IN 46733-1803 | 2011-03-14 |
| 1962736660 | Johnny H Lott Jr. | Optometrist | 2301 Point Mallard Dr Se, Decatur, AL 35601-6741 | 2009-09-28 |
| 1033371729 | Jonathan R Bradley | Optometrist | 4837 E Rt 36, Central Illinois Vision Center, Decatur, IL 62521 | 2008-06-25 |
| 1649482274 | Keith F Fishe | Optometrist | 3580 Memorial Dr, Decatur, GA 30032-2723 | 2007-05-04 |
| 1962524033 | Asfaw Kindeya Natu | Optometrist | 2050 Lawrenceville Hwy Ste D50, Decatur, GA 30033-4316 | 2007-04-06 |
| 1821122060 | Shama Jitendra Patel | Optometrist | 2851 Candler Rd, Suite 100, Decatur, GA 30034-1412 | 2007-03-16 |
| 1306977103 | Marc Vision Care, Ltd. | Optometrist | 2705 N Water St Ste C, Decatur, IL 62526-6502 | 2007-03-07 |
| Find all providers in DECATUR | ||||
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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.