Washington Eye Care Center

Primary specialty

OptometristTaxonomy code 152W00000X

Legal business name

WASHINGTON EYE CARE CENTER

Practice address

122 N Court St Ste 102
Fairfield, IA 52556-2815

Phone

(319) 325-0718

Fax

(641) 472-5979

NPI assigned

Nov 17, 2020

Organization subpart

No

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

Authorized official

Name

Beth Gutierrez

Title

Billing Manager

Phone

(319) 653-4558

Specialties & licenses 1

Addresses

Other names 1

• Axis Vision Care Doing business as

Medicare fee-for-service enrollment

Enrolled in IA2 enrollments

Enrollment records 2

Other NPIs with the same Medicare PAC ID 2

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

• Washington Eye Care Center

  • Optometrist
  • Williamsburg, IA
  • NPI 1417551193

  1254510308

  Same PAC ID
• Washington Eye Care Center

  • Optometrist
  • Washington, IA
  • NPI 1447553474

  1254510308

  Same PAC ID

Other NPIs on the same Medicare enrollment 1

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

• Washington Eye Care Center

  • Optometrist
  • Washington, IA
  • NPI 1447553474

  O20110215000941

  Same enrollment

Tax ID family

Washington Eye Care Center3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

• Washington Eye Care Center

  • Optometrist
  • Williamsburg, IA
  • NPI 1417551193
  NPD tax ID
• Washington Eye Care Center

  • Optometrist
  • Washington, IA
  • NPI 1447553474
  NPD tax ID

Locations

Practitioners 4

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

• Timothy Michael Courtney, O.D.

  • Optometrist
  • Washington, IA
  • NPI 1427256536
  NPD
• Samantha Joann Harris, OD

  • Optometrist
  • Tiffin, IA
  • NPI 1083289581
  NPD
• Cade Millikin

  • Optometrist
  • Fairfield, IA
  • NPI 1720724834
  NPD
• Ryan Lee Striegel, O.D.

  • Optometrist
  • Williamsburg, IA
  • NPI 1144459736
  NPD

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

{
    "created_epoch": "1605571200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1605571200000",
    "number": "1053914705",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 70",
            "city": "WASHINGTON",
            "state": "IA",
            "postal_code": "523530070",
            "telephone_number": "319-653-4558",
            "fax_number": "319-653-2574"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "122 N COURT ST STE 102",
            "city": "FAIRFIELD",
            "state": "IA",
            "postal_code": "525562815",
            "telephone_number": "319-325-0718",
            "fax_number": "641-472-5979"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WASHINGTON EYE CARE CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-11-17",
        "last_updated": "2020-11-17",
        "certification_date": "2020-11-17",
        "status": "A",
        "authorized_official_last_name": "GUTIERREZ",
        "authorized_official_first_name": "BETH",
        "authorized_official_title_or_position": "BILLING MANAGER",
        "authorized_official_telephone_number": "319-653-4558"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Axis Vision Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Lila Ananda Wallace, LMFT
• Walmart Inc.
• Jonathan Weinand, PHD
• Kayla Weirup, RPH
• Christian Andrew Wells, PTA
• Wellspring Chiropractic Clinic PLLC
• Donna Jean Williams, PT, CWS

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 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.

Verify at the official NPI Registry.