NPIMap

Organization Active NPI

Professional Eyecare Management Inc.

  • Optometrist
  • Lawrence, KS
National Provider Identifier
1104305564
Registry record updated Aug 15, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1014-3 Issued in KS
Legal business name
PROFESSIONAL EYECARE MANAGEMENT INC.
Practice address
3201 S Iowa St
Lawrence, KS 66046-5205
Phone
(785) 383-3417
NPI assigned
Aug 7, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2018

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

Authorized official

Name
Dr. John Michael Andersen, OD
Title
Owner
Phone
(402) 540-0017

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 1014-3 KS Primary

Addresses

Primary practice location

3201 S Iowa St
Lawrence, KS 66046-5205

Mailing address

11121 W 95TH St
Overland Park, KS 66214-1824
Phone (785) 838-3417

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 13

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1533600000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1534291200000",
    "number": "1104305564",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11121 W 95TH ST",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662141824",
            "telephone_number": "785-838-3417",
            "fax_number": "913-492-5217"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3201 S IOWA ST",
            "city": "LAWRENCE",
            "state": "KS",
            "postal_code": "660465205",
            "telephone_number": "785-383-3417"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROFESSIONAL EYECARE MANAGEMENT INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-08-07",
        "last_updated": "2018-08-15",
        "status": "A",
        "authorized_official_last_name": "ANDERSEN",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "MICHAEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "402-540-0017",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "KS",
            "license": "1014-3",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lawrence, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2018; 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.