Sidney Vision Clinic LLC

Primary specialty

OptometristTaxonomy code 152W00000X

License

892 Issued in NE

Legal business name

SIDNEY VISION CLINIC LLC

Practice address

900 Pine St
Sidney, NE 69162-2241

Phone

(308) 254-4041

Fax

(308) 254-3718

NPI assigned

Apr 17, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Jeffrey Alan Cook, O.D.

Title

Partner

Phone

(308) 254-4041

Specialties & licenses 6

Addresses

Other identifiers 4

Locations

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

{
    "created_epoch": "1176768000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1582070400000",
    "number": "1073739470",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 61",
            "city": "SIDNEY",
            "state": "NE",
            "postal_code": "691620061",
            "telephone_number": "308-254-4041",
            "fax_number": "308-254-3718"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 PINE ST",
            "city": "SIDNEY",
            "state": "NE",
            "postal_code": "691622241",
            "telephone_number": "308-254-4041",
            "fax_number": "308-254-3718"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SIDNEY VISION CLINIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-17",
        "last_updated": "2020-02-19",
        "certification_date": "2020-02-19",
        "status": "A",
        "authorized_official_last_name": "COOK",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "ALAN",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "308-254-4041",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": "NE",
            "license": "892",
            "primary": true
        },
        {
            "code": "152WC0802X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "NE",
            "license": "892",
            "primary": false
        },
        {
            "code": "152WP0200X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Optometrist, Pediatrics",
            "state": "NE",
            "license": "892",
            "primary": false
        },
        {
            "code": "152WS0006X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Optometrist, Sports Vision",
            "state": "NE",
            "license": "892",
            "primary": false
        },
        {
            "code": "152WV0400X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Optometrist, Vision Therapy",
            "state": "NE",
            "license": "892",
            "primary": false
        },
        {
            "code": "152WX0102X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Optometrist, Occupational Vision",
            "state": "NE",
            "license": "892",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PROVIDER NUMBER",
            "identifier": "37094",
            "state": "NE"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10025341000",
            "state": "NE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UHC RR MEDICARE PROVIDER",
            "identifier": "410025992",
            "state": "NE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MIDLANDS CHOICE PROV NMBR",
            "identifier": "245327",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Corbin Shelor
• Bennie Shimp
• Sara M Sholar, D.O.
• Lori Shutts
• Sidney Care and Rehabilitation Center, LLC
• Sidney Vision Clinic LLC
• Brenna D Simmons, M.S. ED., CF-SLP
• Tami Renee Slife
• Amy Smith
• Annalyn Marie Smith

• Optometrist in Sidney, NE
• Providers in Sidney, NE by specialty
• Optometrist in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2020; 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.