Grene Vision Group LLC

Primary specialty

OptometristTaxonomy code 152W00000X

Legal business name

GRENE VISION GROUP LLC

Practice address

115 E Broadway
Stafford, KS 67578

Phone

(620) 234-5533

Fax

(620) 663-8101

NPI assigned

May 4, 2007

Last updated

Feb 20, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Sheryl Davenport

Title

Insurance Department Supervisor

Phone

(316) 858-3831

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in KS

Enrollment records 1

Other NPIs on the same Medicare enrollment 26

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Grene Vision Group LLC

  • Ophthalmology Physician
  • Wichita, KS
  • NPI 1043422769

  O20040407000095

  Same enrollment
• Grene Vision Group LLC

  • Optometrist
  • Neodesha, KS
  • NPI 1154543981

  O20040407000095

  Same enrollment
• Grene Vision Group LLC

  • Optometrist
  • Wichita, KS
  • NPI 1225240591

  O20040407000095

  Same enrollment
• Grene Vision Group LLC

  • Optometrist
  • Hillsboro, KS
  • NPI 1235341595

  O20040407000095

  Same enrollment
• Grene Vision Group LLC

  • Optometrist
  • Hutchinson, KS
  • NPI 1255543021

  O20040407000095

  Same enrollment
• Grene Vision Group LLC

  • Ophthalmology Physician
  • Wichita, KS
  • NPI 1285627562

  O20040407000095

  Same enrollment
• Grene Vision Group LLC

  • Optometrist
  • Winfield, KS
  • NPI 1295940633

  O20040407000095

  Same enrollment
• Grene Vision Group LLC

  • Optometrist
  • Derby, KS
  • NPI 1417169780

  O20040407000095

  Same enrollment
• Grene Vision Group LLC

  dba Grene Vision Group

  • Optometrist
  • Wichita, KS
  • NPI 1588115000

  O20040407000095

  Same enrollment
• Grene Vision Group LLC

  • Optometrist
  • Anthony, KS
  • NPI 1588876262

  O20040407000095

  Same enrollment
• Grene Vision Group LLC

  dba Grene Vision Group

  • Optometrist
  • Wichita, KS
  • NPI 1598215006

  O20040407000095

  Same enrollment
• Grene Vision Group LLC

  • Optometrist
  • Andover, KS
  • NPI 1598977464

  O20040407000095

  Same enrollment

Locations

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.

• Kristina Lynn Post, O.D.

  • Optometrist
  • Arkansas City, KS
  • NPI 1053399774
  NPD

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

{
    "created_epoch": "1178236800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1203465600000",
    "number": "1104038959",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1851 N WEBB RD",
            "address_2": "ATTN FLR2",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672063413",
            "telephone_number": "316-636-2010",
            "fax_number": "316-691-4408"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 E BROADWAY",
            "city": "STAFFORD",
            "state": "KS",
            "postal_code": "67578",
            "telephone_number": "620-234-5533",
            "fax_number": "620-663-8101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRENE VISION GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-04",
        "last_updated": "2008-02-20",
        "status": "A",
        "authorized_official_last_name": "DAVENPORT",
        "authorized_official_first_name": "SHERYL",
        "authorized_official_title_or_position": "INSURANCE DEPARTMENT SUPERVISOR",
        "authorized_official_telephone_number": "316-858-3831"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Thomas Anderson Bauer, M.D.
• Jill Burbank, PA
• Charles L Craig, PA
• Tamara L Farmer, ARNP
• Raquel Garza
• Heart of Kansas Family Health Care, Inc. (Stafford Clinic Site)
• Leisure Homestead Association (Leisure Homestead at Stafford)
• Leisure Homestead Association (Home Plus)
• Alicia Sue Minks
• Stafford County Hospital

• Optometrist in Stafford, KS
• Providers in Stafford, KS by specialty
• Optometrist in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2008; 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.