Central Iowa Family Eyecare PLLC

Primary specialty

OptometristTaxonomy code 152W00000X

License

02356 Issued in IA

Legal business name

CENTRAL IOWA FAMILY EYECARE PLLC

Practice address

207 N Chestnut St
Jefferson, IA 50129-1906

Phone

(515) 386-3513

NPI assigned

Aug 22, 2018

Organization subpart

No

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

Authorized official

Name

Dr. Kyle Stalder, ODNPI 1720019029

Title

Owner

Phone

(515) 386-2640

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IA

Enrollment records 1

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Central Iowa Family Eyecare PLLC

  • Optometrist
  • Guthrie Center, IA
  • NPI 1447731963

  O20181004002790

  Same enrollment

Tax ID family

Central Iowa Family Eyecare PLLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Central Iowa Family Eyecare PLLC

  • Optometrist
  • Guthrie Center, IA
  • NPI 1447731963
  NPD tax ID

Practitioners 1

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

• Kyle John Stalder, O.D.

  • Optometrist
  • Jefferson, IA
  • NPI 1720019029
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1534896000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1534896000000",
    "number": "1023599685",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 228",
            "city": "JEFFERSON",
            "state": "IA",
            "postal_code": "501290228",
            "telephone_number": "515-386-3513"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "207 N CHESTNUT ST",
            "city": "JEFFERSON",
            "state": "IA",
            "postal_code": "501291906",
            "telephone_number": "515-386-3513"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "405 State St",
            "address_purpose": "LOCATION",
            "city": "Guthrie Center",
            "state": "IA",
            "postal_code": "501151353",
            "country_code": "US",
            "telephone_number": "641-747-8207",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "CENTRAL IOWA FAMILY EYECARE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-08-22",
        "last_updated": "2018-08-22",
        "status": "A",
        "authorized_official_last_name": "STALDER",
        "authorized_official_first_name": "KYLE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "515-386-2640",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "IA",
            "license": "02356",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• John Bryan Brunow
• Mark Francis Buettner, DO
• Carroll Apothecary, Inc
• Maribel Castellanos, FNP-C
• Centers for Long Term Care of Iowa
• Columba Chukwubuikem Chukwuka, M.D
• Julie W. Clark, MS, RD, LD, CDE
• Laurie Lynn Connolly, M.D.
• County of Greene
• Taylan Entriken

• Optometrist in Jefferson, IA
• Providers in Jefferson, IA by specialty
• Optometrist in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2018; 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.