State Line Eye Care Center, PC

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

Legal business name

STATE LINE EYE CARE CENTER, PC

Doing business as

Brookside Eye Care Center

Practice address

520 E 63Rd St
Brookside Eye Care Center
Kansas City, MO 64110-3330

Phone

(816) 333-8600

Fax

(816) 444-3304

NPI assigned

May 26, 2009

Last updated

May 18, 2022By 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

Lilliam (Lily) S Yohn

Title

Office Manager

Phone

(816) 333-8600

Specialties & licenses 1

Addresses

Other names 1

• Brookside Eye Care Center Doing business as

Locations

Practitioners 1

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.

• Thomas J Whittaker, M.D.

  • Ophthalmology Physician
  • Prairie Village, KS
  • NPI 1699831206
  NPD (past)

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

{
    "created_epoch": "1243296000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1652832000000",
    "number": "1013142694",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "520 E 63RD ST",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641103330",
            "telephone_number": "816-333-8600",
            "fax_number": "816-444-3304"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "520 E 63RD ST",
            "address_2": "BROOKSIDE EYE CARE CENTER",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641103330",
            "telephone_number": "816-333-8600",
            "fax_number": "816-444-3304"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STATE LINE EYE CARE CENTER, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-05-26",
        "last_updated": "2022-05-18",
        "certification_date": "2022-05-18",
        "status": "A",
        "authorized_official_last_name": "YOHN",
        "authorized_official_first_name": "LILLIAM (LILY)",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "816-333-8600"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Brookside Eye Care Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Brookside Eye Care Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Sarah Lee Starnes, MSW
• Debra Pomroy Starr
• Kristin Starr
• Patrick Joseph Starr Sr.
• Nickolas Stasic, M.D.
• State Line Eye Care Center, PC (State Line Eye Care Center Optical)
• State Line Eye Care Center, PC
• State Line Medical Group LLC
• State Line Psychiatric Consultants LLC
• State of Missouri (Kansas City Regional Center)

• Ophthalmology Physician in Kansas City, MO
• Providers in Kansas City, MO by specialty
• Ophthalmology Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2022; 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.