Gracie Chase Avery, LLC

Primary specialty

OptometristTaxonomy code 152W00000X

License

T03487 Issued in MO

Legal business name

GRACIE CHASE AVERY, LLC

Doing business as

4States Vision Express

Practice address

1703 W 30TH St Ste B
Joplin, MO 64804-1519

Phone

(417) 952-2366

Fax

(417) 952-2367

NPI assigned

Nov 20, 2017

Last updated

Oct 31, 2026By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Kevin Michael Gardner, ODNPI 1346358769

Title

Owner

Phone

(417) 499-7715

Specialties & licenses 1

Addresses

Other names 1

• 4States Vision Express Doing business as

Medicare fee-for-service enrollment

Enrolled in MO, KS2 enrollments

Enrollment records 2

Locations

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Kevin M Gardner, OD

  • Optometrist
  • Joplin, MO
  • NPI 1346358769

  KS

  Medicare reassignment Care Compare group NPD Authorized official
• Jamie Buckingham-James, OD

  • Optometrist
  • Joplin, MO
  • NPI 1548735590

  KS

  Medicare reassignment Care Compare group NPD
• Madison Sue White, OD

  • Optometrist
  • Joplin, MO
  • NPI 1245914456

  KS

  Medicare reassignment Care Compare group NPD
• Bradley R Wimmer, O.D.

  • Optometrist
  • Pittsburg, KS
  • NPI 1699700807
  NPD
• Steven K Younger, M.D.

  • Family Medicine Physician
  • Neosho, MO
  • NPI 1417050204
  NPD (past)
• Kimberly Balk

  • Optician
  • Pittsburg, KS
  • NPI 1972909679
  NPD (past)
• Christopher J Jacquinot, O.D.

  • Optometrist
  • Pittsburg, KS
  • NPI 1003016361
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1511136000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1793404800000",
    "number": "1003320607",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1703 W 30TH ST STE B",
            "city": "JOPLIN",
            "state": "MO",
            "postal_code": "648041519",
            "telephone_number": "417-952-2366",
            "fax_number": "417-952-2367"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1703 W 30TH ST STE B",
            "city": "JOPLIN",
            "state": "MO",
            "postal_code": "648041519",
            "telephone_number": "417-952-2366",
            "fax_number": "417-952-2367"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRACIE CHASE AVERY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-11-20",
        "last_updated": "2026-10-31",
        "certification_date": "2026-10-31",
        "status": "A",
        "authorized_official_last_name": "GARDNER",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_middle_name": "MICHAEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "417-499-7715",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": "MO",
            "license": "T03487",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "4States Vision Express",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Kelly S Gorman, MD
• Francine Lea Gory, M.A. CCC-SLP, CBIS
• Brandy Gotti
• GPS Adc of Joplin and Dr. John Durling II, DDS, LLC (ADC Dental Group)
• Guy Michael Grabau, MD
• Jeremy Cash Graddy, DPT
• Geoffrey Glen Graham, DO
• Grand Falls Center for Recovery LLC
• Grant T Kirk DDS LLC (Joplin Family Dental)
• David Glenn Grant, O.D.

• Optometrist in Joplin, MO
• Providers in Joplin, MO by specialty
• Optometrist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.