Organization Active NPI

Rock River Optical LLC

  • Optometrist
  • Fort Atkinson, WI
National Provider Identifier
1134859887
Registry record updated Jun 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
ROCK RIVER OPTICAL LLC
Practice address
232 S Main St
Fort Atkinson, WI 53538-2228
Phone
(920) 542-1501
Fax
(920) 542-1503
NPI assigned
Jun 15, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 15, 2022

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

Authorized official

Name
Amanda CheekNPI 1457647125
Title
Optometrist
Phone
(920) 728-2350

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

232 S Main St
Fort Atkinson, WI 53538-2228

Mailing address

232 S Main St
Fort Atkinson, WI 53538-2228
Phone (920) 542-1501

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220725001894 WI Part B Supplier - Clinic/Group Practice 5991186702 Receives reassigned benefits from 1 practitioner
Practice locations: Fort Atkinson, WI

National Provider Directory

National Provider Directory

Locations

232 S Main St
Fort Atkinson, WI 53538
Phone (920) 542-1050

Practitioners & affiliated clinicians

Practitioners 2

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": "1655251200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1655251200000",
    "number": "1134859887",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "232 S MAIN ST",
            "city": "FORT ATKINSON",
            "state": "WI",
            "postal_code": "535382228",
            "telephone_number": "920-542-1501",
            "fax_number": "920-542-1503"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "232 S MAIN ST",
            "city": "FORT ATKINSON",
            "state": "WI",
            "postal_code": "535382228",
            "telephone_number": "920-542-1501",
            "fax_number": "920-542-1503"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROCK RIVER OPTICAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-06-15",
        "last_updated": "2022-06-15",
        "certification_date": "2022-06-15",
        "status": "A",
        "authorized_official_last_name": "CHEEK",
        "authorized_official_first_name": "AMANDA",
        "authorized_official_title_or_position": "OPTOMETRIST",
        "authorized_official_telephone_number": "920-728-2350"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Atkinson, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2022; 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.