Envision Eyecare, LLC

Primary specialty

OptometristTaxonomy code 152W00000X

License

2003000960 Issued in MO

Legal business name

ENVISION EYECARE, LLC

Practice address

215 SE State Route 291
Lees Summit, MO 64063-2939

Phone

(816) 246-7779

Fax

(816) 246-7780

NPI assigned

Jul 31, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Joshua Clyde Cantrell, O.D.NPI 1326087594

Title

Executive Member

Phone

(816) 246-7779

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Envision Eyecare Doing business as

Medicare fee-for-service enrollment

Enrolled in MO

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Joshua Clyde Cantrell, OD

  • Optometrist
  • Lees Summit, MO
  • NPI 1326087594
  Medicare reassignment Care Compare group NPD Authorized official
• Patricia R Cantrell, O.D.

  • Optometrist
  • Lees Summit, MO
  • NPI 1205857505
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1154304000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1214870400000",
    "number": "1023023496",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "215 SE STATE ROUTE 291",
            "city": "LEES SUMMIT",
            "state": "MO",
            "postal_code": "640632939",
            "telephone_number": "816-246-7779",
            "fax_number": "816-246-7780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "215 SE STATE ROUTE 291",
            "city": "LEES SUMMIT",
            "state": "MO",
            "postal_code": "640632939",
            "telephone_number": "816-246-7779",
            "fax_number": "816-246-7780"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ENVISION EYECARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-31",
        "last_updated": "2008-07-01",
        "status": "A",
        "authorized_official_last_name": "CANTRELL",
        "authorized_official_first_name": "JOSHUA",
        "authorized_official_middle_name": "CLYDE",
        "authorized_official_title_or_position": "EXECUTIVE MEMBER",
        "authorized_official_telephone_number": "816-246-7779",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "MO",
            "license": "2003000960",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "39170011",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Envision Eyecare",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Empowerme Rehabilitation Mo Agency
• Robert Grey Endres, DSW, LCSW
• Jeffrey Enevoldsen, O.D.
• Amber England, LPC
• Sara C English, OTR/L
• Jennifer I Enyeribe
• Epc Mo Aco LLC
• Karen L Epperson, M.D
• Krystina Erichsen
• Lisa M Erickson, LCSW

• Optometrist in Lees Summit, MO
• Providers in Lees Summit, MO by specialty
• Optometrist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2008; 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.