NPIMap

Organization Active NPI

Idea to Grow

  • Eyewear Supplier
  • Grand Prairie, TX
National Provider Identifier
1003411489
Registry record updated Feb 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Eyewear SupplierTaxonomy code 332H00000X
Legal business name
IDEA TO GROW
Practice address
1050 Mayfield Rd Ste 100
Grand Prairie, TX 75052-6043
Phone
(469) 865-1380
Fax
(561) 828-8367
NPI assigned
Dec 2, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 19, 2021

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

Authorized official

Name
Jacke Bennett
Title
Credentialing Manager
Phone
(561) 612-4531

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Eyewear Supplier 332H00000X Primary

Addresses

Primary practice location

1050 Mayfield Rd Ste 100
Grand Prairie, TX 75052-6043

Mailing address

1050 Mayfield Rd Ste 100
Grand Prairie, TX 75052-6043
Phone (561) 275-2020

National Provider Directory

National Provider Directory
Tax ID family
Idea to Grow LLC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1050 Mayfield Rd
Ste 100
Grand Prairie, TX 75052
Phone (469) 865-1380

NPI Registry JSON

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

{
    "created_epoch": "1606867200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1613692800000",
    "number": "1003411489",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1050 MAYFIELD RD STE 100",
            "city": "GRAND PRAIRIE",
            "state": "TX",
            "postal_code": "750526043",
            "telephone_number": "561-275-2020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1050 MAYFIELD RD STE 100",
            "city": "GRAND PRAIRIE",
            "state": "TX",
            "postal_code": "750526043",
            "telephone_number": "469-865-1380",
            "fax_number": "561-828-8367"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IDEA TO GROW",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-12-02",
        "last_updated": "2021-02-19",
        "certification_date": "2021-02-19",
        "status": "A",
        "authorized_official_last_name": "BENNETT",
        "authorized_official_first_name": "JACKE",
        "authorized_official_title_or_position": "CREDENTIALING MANAGER",
        "authorized_official_telephone_number": "561-612-4531"
    },
    "taxonomies": [
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Prairie, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.