Organization Active NPI

Family Eye Care PC

  • Optometrist
  • Denison, IA
National Provider Identifier
1134199722
Registry record updated Apr 20, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
FAMILY EYE CARE PC
Practice address
1504 5TH Ave S
Denison, IA 51442-2004
Phone
(712) 263-5654
Fax
(712) 263-8811
NPI assigned
Jan 25, 2006
Last updated
Apr 20, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2008

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

Authorized official

Name
Terry L Brown, ODNPI 1992786354
Title
President
Phone
(712) 263-5654

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
Optometrist 152W00000X NU Primary

Addresses

Primary practice location

1504 5TH Ave S
Denison, IA 51442-2004

Mailing address

PO Box 482
Denison, IA 51442-0482
Phone (712) 263-5654

Other identifiers 1

IdentifierTypeStateIssuer
2792283MedicaidIA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040406000837 IA Part B Supplier - Clinic/Group Practice 6800889833 Receives reassigned benefits from 2 practitioners
Practice locations: Denison, IA
O20100930012820 IA DME Supplier - Physician - Optometrist 6800889833 Practice locations: Denison, IA

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.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Family Eye Care PC1504 5TH Ave S, Denison, IA 51442-2004(712) 263-5654 Prosthetic Lenses: Conventional Eyeglasses|Prosthetic Lenses: Conventional Contact Lenses|Prosthetic Lenses: Prosthetics Cataract Lenses Accepts assignmentParticipating since Mar 16, 1994

National Provider Directory

National Provider Directory

Locations

1504 5th Ave S
Denison, IA 51442
Phone (712) 263-5654

Practitioners & affiliated clinicians

Practitioners 5

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": "1138147200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208649600000",
    "number": "1134199722",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 482",
            "city": "DENISON",
            "state": "IA",
            "postal_code": "514420482",
            "telephone_number": "712-263-5654",
            "fax_number": "712-263-8811"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1504 5TH AVE S",
            "city": "DENISON",
            "state": "IA",
            "postal_code": "514422004",
            "telephone_number": "712-263-5654",
            "fax_number": "712-263-8811"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY EYE CARE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-25",
        "last_updated": "2008-04-20",
        "status": "A",
        "authorized_official_last_name": "BROWN",
        "authorized_official_first_name": "TERRY",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "712-263-5654",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2792283",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Denison, IA

Sources for this page

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