Active NPI
Advanced Eye Care of Winfield LLC
Doing business as Advanced Eye Care
- Optometrist
- Troy, MO
National Provider Identifier
1013143957
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- T03408
- Legal business name
- ADVANCED EYE CARE OF WINFIELD LLC
- Doing business as
- Advanced Eye Care
- Practice address
- 43 Ellis Ave
Troy, MO 63379-1151 - Phone
- (636) 528-4144
- NPI assigned
- Jun 5, 2009
- Last updated
- Jan 27, 2020
- Organization subpart
- Yes
- Parent organization
- ADVANCED EYE CARE OF WINFIELD
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Denise M Harvey, OD
- Title
- Managing Member
- Phone
- (573) 324-3131
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | T03408 | MO | Primary |
| Optometrist | 152W00000X | 2008017063 | MO | |
| Optometrist | 152W00000X | 2007018394 | MO |
Addresses
Primary practice location
43 Ellis Ave
Troy, MO 63379-1151
Mailing address
43 Ellis Ave
Troy, MO 63379-1151
Phone (636) 528-4144
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1265473383 | Medicaid | MO | |
| 1811159882 | Medicaid | MO | |
| 1609305580 | Medicaid | MO |
Other names 1
- Advanced Eye Care
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MO
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20080318000661 | MO | Part B Supplier - Clinic/Group Practice | 5799861639 |
Receives reassigned benefits from 3 practitioners 1 other NPI on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Troy, MO; Winfield, MO |
Other NPIs on the same Medicare enrollment 1
NPIs listed together on one Medicare enrollment, typically parts of the same organization.
National Provider Directory
National Provider Directory- Tax ID family
- Advanced Eyecare Winfld LLC
- Part of
- Advanced Eyecare Winfld LLC
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Optometrist
- Winfield, MO
- NPI 1053599472
Locations
102 Eagles Bluff Hts
Winfield, MO 63389
Phone (636) 668-6171
Practitioners & affiliated clinicians
Practitioners 3
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.
-
- Optometrist
- Bowling Green, MO
- NPI 1265473383
-
- Optometrist
- Winfield, MO
- NPI 1811159882
-
- Optometrist
- Bowling Green, MO
- NPI 1609305580
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1244160000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1580083200000",
"number": "1013143957",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "43 ELLIS AVE",
"city": "TROY",
"state": "MO",
"postal_code": "633791151",
"telephone_number": "636-528-4144"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "43 ELLIS AVE",
"city": "TROY",
"state": "MO",
"postal_code": "633791151",
"telephone_number": "636-528-4144"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "ADVANCED EYE CARE OF WINFIELD LLC",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "ADVANCED EYE CARE OF WINFIELD",
"enumeration_date": "2009-06-05",
"last_updated": "2020-01-27",
"certification_date": "2020-01-27",
"status": "A",
"authorized_official_last_name": "HARVEY",
"authorized_official_first_name": "DENISE",
"authorized_official_middle_name": "M",
"authorized_official_title_or_position": "MANAGING MEMBER",
"authorized_official_telephone_number": "573-324-3131",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "OD"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "MO",
"license": "T03408",
"primary": true
},
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "MO",
"license": "2008017063",
"primary": false
},
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "MO",
"license": "2007018394",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1265473383",
"state": "MO"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1811159882",
"state": "MO"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1609305580",
"state": "MO"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Advanced Eye Care",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "Advanced Eye Care",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Troy, MO
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- Air Evac EMS Inc (Air Evac Lifeteam)
- All Family Chiropractic LLC
- Pamela Gay Allen, LCSW
- Leticia Lanay Allison-Clark, LICENSED MASSAGE THE
- Almus Family Chiropractic, LLC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2020; 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.