Organization Active NPI

Eye Care of Iowa P.C.

  • Optometrist
  • West Des Moines, IA
National Provider Identifier
1073544201
Registry record updated Mar 6, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
152W00000X Issued in IA
Legal business name
EYE CARE OF IOWA P.C.
Practice address
1905 Ep True Pkwy
Ste 103
West Des Moines, IA 50265-7056
Phone
(515) 225-0877
NPI assigned
Jul 5, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 6, 2008

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

Authorized official

Name
Dr. Bernard Eugene Lee, O.D.
Title
Secretary
Phone
(515) 225-0877

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 152W00000X IA Primary

Addresses

Primary practice location

1905 Ep True Pkwy
Ste 103
West Des Moines, IA 50265-7056

Mailing address

1905 Ep True Pkwy
Ste 103
West Des Moines, IA 50265-7056

Other identifiers 1

IdentifierTypeStateIssuer
0416891MedicaidIA

National Provider Directory

National Provider Directory

Locations

1905 Ep True Pkwy
Ste 103
West Des Moines, IA 50265
Phone (515) 225-0877

Practitioners & affiliated clinicians

Practitioners 1

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": "1152057600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1204761600000",
    "number": "1073544201",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1905 EP TRUE PKWY",
            "address_2": "STE 103",
            "city": "WEST DES MOINES",
            "state": "IA",
            "postal_code": "502657056"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1905 EP TRUE PKWY",
            "address_2": "STE 103",
            "city": "WEST DES MOINES",
            "state": "IA",
            "postal_code": "502657056",
            "telephone_number": "515-225-0877"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EYE CARE OF IOWA P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-05",
        "last_updated": "2008-03-06",
        "status": "A",
        "authorized_official_last_name": "LEE",
        "authorized_official_first_name": "BERNARD",
        "authorized_official_middle_name": "EUGENE",
        "authorized_official_title_or_position": "SECRETARY",
        "authorized_official_telephone_number": "515-225-0877",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "IA",
            "license": "152W00000X",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0416891",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in West Des Moines, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2008; 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.