Organization Active NPI

Village Eye Doc LLC

  • Optometrist
  • Branson West, MO
National Provider Identifier
1073376752
Registry record updated Nov 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
VILLAGE EYE DOC LLC
Practice address
18593 Business 13 Ste 206
Branson West, MO 65737-9319
Phone
(417) 527-5787
Fax
(417) 785-2452
NPI assigned
Feb 5, 2024
Last updated
Nov 26, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 26, 2024

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

Authorized official

Name
Dana E Turner, ODNPI 1336175199
Title
Authorized Official/President/OD
Phone
(417) 527-5787

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 Primary

Addresses

Primary practice location

18593 Business 13 Ste 206
Branson West, MO 65737-9319

Mailing address

18593 Business 13 Ste 206
Branson West, MO 65737-9319
Phone (417) 527-5787

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240329001636 MO Part B Supplier - Clinic/Group Practice 3476991225 Receives reassigned benefits from 1 practitioner
Practice locations: Branson West, MO

National Provider Directory

National Provider Directory

Locations

18593 Business 13
Ste 206
Reeds Spring, MO 65737
Phone (417) 444-3364

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1707091200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1732579200000",
    "number": "1073376752",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18593 BUSINESS 13 STE 206",
            "city": "BRANSON WEST",
            "state": "MO",
            "postal_code": "657379319",
            "telephone_number": "417-527-5787",
            "fax_number": "417-785-2452"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18593 BUSINESS 13 STE 206",
            "city": "BRANSON WEST",
            "state": "MO",
            "postal_code": "657379319",
            "telephone_number": "417-527-5787",
            "fax_number": "417-785-2452"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VILLAGE EYE DOC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-02-05",
        "last_updated": "2024-11-26",
        "certification_date": "2024-11-26",
        "status": "A",
        "authorized_official_last_name": "TURNER",
        "authorized_official_first_name": "DANA",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL/PRESIDENT/OD",
        "authorized_official_telephone_number": "417-527-5787",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Branson West, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 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.