NPIMap

Organization Active NPI

Wichita Optometry, P.a.

  • Optometrist
  • Wichita, KS
National Provider Identifier
1083676936
Registry record updated Jun 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
WICHITA OPTOMETRY, P.A.
Practice address
2635 W Douglas Ave
Wichita, KS 67213
Phone
(316) 942-7496
Fax
(316) 239-2557
NPI assigned
Apr 5, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2021

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

Authorized official

Name
Dr. Jeffrey H Yarrow, ODNPI 1699737544
Title
President
Phone
(316) 942-7496

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

2635 W Douglas Ave
Wichita, KS 67213

Mailing address

2635 W Douglas Ave
Wichita, KS 67213
Phone (316) 942-7496

Other practice location 1

2330 N Amidon Ave
Wichita, KS 67204-5630
Phone (316) 942-7496

Other practice location 2

12111 W Maple St Ste 125
Wichita, KS 67235-8756
Phone (316) 942-7496

Other practice location 3

415 SE Louis Dr
Mulvane, KS 67110-1205
Phone (316) 942-7496

Other names 1

  • Drs. Fisher, Yarrow, & Fleming, P.A. Former legal business name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20080502000609 KS Part B Supplier - Clinic/Group Practice 2567541451 Receives reassigned benefits from 11 practitioners
Practice locations: Mulvane, KS; Wichita, KS
O20100930050390 KS DME Supplier - Physician - Optometrist 2567541451 Practice locations: Wichita, KS

Other NPIs with the same Medicare PAC ID 3

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

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
17D2141360Wichita Optometry PA2635 W Douglas, Wichita, KS 67213Certificate of waiverDec 11, 2027

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Wichita Optometry PA2635 W Douglas Ave, Wichita, KS 67213-2605(316) 942-7498 Prosthetic Lenses: Conventional Eyeglasses|Prosthetic Lenses: Conventional Contact Lenses Accepts assignmentParticipating since Jan 1, 2002

National Provider Directory

National Provider Directory
Tax ID family
Wichita Optometry PA2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Locations

2330 N Amidon Ave
Wichita, KS 67204
Phone (316) 838-7797

2635 W Douglas Ave
Wichita, KS 67213
Phone (316) 942-7496

Ownership & related parties

Subparts reporting this organization as parent 4

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 11

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": "1144195200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1625011200000",
    "number": "1083676936",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2635 W DOUGLAS AVE",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "67213",
            "telephone_number": "316-942-7496",
            "fax_number": "316-942-9431"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2635 W DOUGLAS AVE",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "67213",
            "telephone_number": "316-942-7496",
            "fax_number": "316-239-2557"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2330 N Amidon Ave",
            "address_purpose": "LOCATION",
            "city": "Wichita",
            "state": "KS",
            "postal_code": "672045630",
            "country_code": "US",
            "telephone_number": "316-942-7496",
            "fax_number": "316-239-2557",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "12111 W Maple St Ste 125",
            "address_purpose": "LOCATION",
            "city": "Wichita",
            "state": "KS",
            "postal_code": "672358756",
            "country_code": "US",
            "telephone_number": "316-942-7496",
            "fax_number": "316-239-2557",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "415 SE Louis Dr",
            "address_purpose": "LOCATION",
            "city": "Mulvane",
            "state": "KS",
            "postal_code": "671101205",
            "country_code": "US",
            "telephone_number": "316-942-7496",
            "fax_number": "316-239-2557",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "WICHITA OPTOMETRY, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-05",
        "last_updated": "2021-06-30",
        "certification_date": "2021-06-30",
        "status": "A",
        "authorized_official_last_name": "YARROW",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "316-942-7496",
        "authorized_official_name_prefix": "Dr.",
        "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": [
        {
            "organization_name": "Drs. Fisher, Yarrow, & Fleming, P.A.",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "Drs. Fisher, Yarrow, & Fleming, P.A.",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Wichita, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.