NPIMap

Organization Active NPI

Midwest Eye Care PC

  • Optician
  • Council Bluffs, IA
National Provider Identifier
1093867301
Registry record updated Jan 30, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
OpticianTaxonomy code 156FX1800X
Legal business name
MIDWEST EYE CARE PC
Practice address
715 Harmony St Ste 300
Council Bluffs, IA 51503-3147
Phone
(402) 552-2020
NPI assigned
Jan 17, 2007
Last updated
Jan 30, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2014

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

Authorized official

Name
Jay Slagle
Title
Ceo
Phone
(402) 552-2020

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optician 156FX1800X NU Primary

Addresses

Primary practice location

715 Harmony St Ste 300
Council Bluffs, IA 51503-3147

Mailing address

4353 Dodge St
Omaha, NE 68131-2709
Phone (402) 552-2020

Other identifiers 1

IdentifierTypeStateIssuer
0208140MedicaidIA

National Provider Directory

National Provider Directory
Tax ID family
Midwest Eye Care PC11 organizations share this tax ID, including this one

Other organizations with this tax ID 10

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

Locations

715 Harmony St
Ste 300
Council Bluffs, IA 51503
Phone (712) 388-2600

4353 Dodge St
Omaha, NE 68131
Phone (402) 502-5599

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": "1168992000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1391040000000",
    "number": "1093867301",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4353 DODGE ST",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681312709",
            "telephone_number": "402-552-2020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "715 HARMONY ST STE 300",
            "city": "COUNCIL BLUFFS",
            "state": "IA",
            "postal_code": "515033147",
            "telephone_number": "402-552-2020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIDWEST EYE CARE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-17",
        "last_updated": "2014-01-30",
        "status": "A",
        "authorized_official_last_name": "SLAGLE",
        "authorized_official_first_name": "JAY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "402-552-2020"
    },
    "taxonomies": [
        {
            "code": "156FX1800X",
            "taxonomy_group": "",
            "desc": "Technician/Technologist, Optician",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0208140",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Council Bluffs, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2014; 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.