Organization Active NPI

Woodland Eye Clinic, PC

  • Optometrist
  • Dyersville, IA
National Provider Identifier
1053741983
Registry record updated Feb 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2461 Issued in IA
Legal business name
WOODLAND EYE CLINIC, PC
Practice address
1129 11TH St SE
Suite B
Dyersville, IA 52040-2418
Phone
(563) 581-0923
NPI assigned
Nov 13, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 22, 2024

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

Authorized official

Name
Dr. Joshua Aaron Woodland, ODNPI 1699784868
Title
President
Phone
(563) 581-0923

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
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 2461 IA Primary

Addresses

Primary practice location

1129 11TH St SE
Suite B
Dyersville, IA 52040-2418

Mailing address

320 E Union St
Manchester, IA 52057-1429

Other names 1

  • The Woodland Eye Clinic Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140203001550 IA Part B Supplier - Clinic/Group Practice 4486883998 Receives reassigned benefits from 5 practitioners
2 other NPIs on this enrollment
Practice locations: West Union, IA; Elkader, IA; Dyersville, IA

Other NPIs on the same Medicare enrollment 2

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

National Provider Directory

National Provider Directory

Locations

808 Wacker Dr
Dubuque, IA 52002
Phone (319) 557-1133

1129 11th St SE
Ste B
Dyersville, IA 52040
Phone (563) 581-0923

Practitioners & affiliated clinicians

Practitioners 5

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

NPI Registry JSON

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

{
    "created_epoch": "1384300800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1708560000000",
    "number": "1053741983",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "320 E UNION ST",
            "city": "MANCHESTER",
            "state": "IA",
            "postal_code": "520571429"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1129 11TH ST SE",
            "address_2": "SUITE B",
            "city": "DYERSVILLE",
            "state": "IA",
            "postal_code": "520402418",
            "telephone_number": "563-581-0923"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WOODLAND EYE CLINIC, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-11-13",
        "last_updated": "2024-02-22",
        "certification_date": "2024-02-22",
        "status": "A",
        "authorized_official_last_name": "WOODLAND",
        "authorized_official_first_name": "JOSHUA",
        "authorized_official_middle_name": "AARON",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "563-581-0923",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "IA",
            "license": "2461",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Woodland Eye Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Dyersville, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2024; 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.