NPIMap

Organization Active NPI

Eye Guys

Doing business as The Eye Guys

  • Optometrist
  • Wasilla, AK
National Provider Identifier
1053646570
Registry record updated Oct 16, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
212 Issued in AK
Legal business name
EYE GUYS
Doing business as
The Eye Guys
Practice address
390 N Main St
Wasilla, AK 99654-7017
Phone
(907) 376-3917
Fax
(907) 376-3967
NPI assigned
Oct 16, 2009
Last updated
Oct 16, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 16, 2009

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

Authorized official

Name
Dr. Edward Carl Godnig Jr., O.D.NPI 1730186867
Title
Owner
Phone
(907) 439-3917

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 212 AK Primary

Addresses

Primary practice location

390 N Main St
Wasilla, AK 99654-7017

Mailing address

390 N Main St
Wasilla, AK 99654-7017
Phone (907) 376-3917

Other identifiers 2

IdentifierTypeStateIssuer
161057OtherMEDICARE PTAN
OD4478MedicaidAK

Other names 1

  • The Eye Guys Doing business as

National Provider Directory

National Provider Directory

Locations

285 E Parks Hwy
Wasilla, AK 99654
Phone (907) 376-3917

390 N Main St
Wasilla, AK 99654
Phone (907) 376-3917

Practitioners & affiliated clinicians

Practitioners 14

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.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1255651200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1255651200000",
    "number": "1053646570",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "390 N MAIN ST",
            "city": "WASILLA",
            "state": "AK",
            "postal_code": "996547017",
            "telephone_number": "907-376-3917",
            "fax_number": "907-376-3967"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "390 N MAIN ST",
            "city": "WASILLA",
            "state": "AK",
            "postal_code": "996547017",
            "telephone_number": "907-376-3917",
            "fax_number": "907-376-3967"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EYE GUYS",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-10-16",
        "last_updated": "2009-10-16",
        "status": "A",
        "authorized_official_last_name": "GODNIG",
        "authorized_official_first_name": "EDWARD",
        "authorized_official_middle_name": "CARL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "907-439-3917",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "AK",
            "license": "212",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "161057",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "OD4478",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Eye Guys",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Wasilla, AK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2009; 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.