Eastern Iowa Health Center

Primary specialty

OptometristTaxonomy code 152W00000X

Legal business name

EASTERN IOWA HEALTH CENTER

Practice address

1210 4TH Ave SE
Cedar Rapids, IA 52403-4085

Phone

(319) 730-7300

NPI assigned

Jan 14, 2026

Last updated

Jan 14, 2026By 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

James Lock

Title

Ceo

Phone

(319) 730-7300

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in IA

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1144188574. Details of each certification follow.

• CCN 161053 Federally qualified health center · Active · Details

Federally qualified health center certification: CCN 161053

Legal name

EASTERN IOWA HEALTH CENTER

Doing business as

EASTERN IOWA HEALTH CENTER OPTOMETRY

Certification status

Active

Provider type (POS)

Federally qualified health center

Participating since

Mar 24, 2026

Last certification

Mar 24, 2026

Ownership / control type

For profit – corporation

Organization structure

CorporationNon-profit

Enrollment address

1210 4TH Ave SE
Cedar Rapids, IA 52403-4085

Other NPIs with the same Medicare PAC ID 4

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

• Eastern Iowa Health Center

  dba Eastern Iowa Health Center Pharmacy

  • Community/Retail Pharmacy
  • Cedar Rapids, IA
  • NPI 1346048675

  0648364828

  Same PAC ID
• Eastern Iowa Health Center

  dba Eastern Iowa Dental Center

  • General Practice Dentistry
  • Cedar Rapids, IA
  • NPI 1437600053

  0648364828

  Same PAC ID
• Eastern Iowa Health Center

  • Family Medicine Physician
  • Cedar Rapids, IA
  • NPI 1578753703

  0648364828

  Same PAC ID
• Eastern Iowa Health Center

  • Family Medicine Physician
  • Cedar Rapids, IA
  • NPI 1598216244

  0648364828

  Same PAC ID

Tax ID family

Eastern Iowa Health Center4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

• Eastern Iowa Health Center

  dba Eastern Iowa Health Center Pharmacy

  • Community/Retail Pharmacy
  • Cedar Rapids, IA
  • NPI 1346048675
  NPD tax ID
• Eastern Iowa Health Center

  dba Eastern Iowa Dental Center

  • General Practice Dentistry
  • Cedar Rapids, IA
  • NPI 1437600053
  NPD tax ID
• Eastern Iowa Health Center

  • Family Medicine Physician
  • Cedar Rapids, IA
  • NPI 1578753703
  NPD tax ID

All disclosed owners & managing parties 20

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

Owners & managing parties with NPI records 3

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

• Angelique A Andrews, MD

  • Pediatrics Physician
  • Cedar Rapids, IA
  • NPI 1720286115

  Corporate Officer, W-2 Managing Employee

  CMS ownership
• Evan James Diehl, M.D.

  • Internal Medicine Physician
  • Cedar Rapids, IA
  • NPI 1255626925

  Corporate Director

  CMS ownership
• Srikanth Sankar Ravisankar, M.D.

  • Pediatrics Physician
  • Greenville, NC
  • NPI 1225267594

  Corporate Director

  CMS ownership

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

{
    "created_epoch": "1768348800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1768348800000",
    "number": "1144188574",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1030 5TH AVE SE STE 2400",
            "city": "CEDAR RAPIDS",
            "state": "IA",
            "postal_code": "524032478",
            "telephone_number": "319-730-7363"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1210 4TH AVE SE",
            "city": "CEDAR RAPIDS",
            "state": "IA",
            "postal_code": "524034085",
            "telephone_number": "319-730-7300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EASTERN IOWA HEALTH CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-01-14",
        "last_updated": "2026-01-14",
        "certification_date": "2026-01-14",
        "status": "A",
        "authorized_official_last_name": "LOCK",
        "authorized_official_first_name": "JAMES",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "319-730-7300"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://easterniowahealthcenter.com/",
            "affiliation": "N",
            "address_1": "1210 4th Ave SE",
            "city": "Cedar Rapids",
            "state": "IA",
            "country_code": "US",
            "postal_code": "524034085",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Cortney Earhart, BSW
• Ease in Essence, PLLC
• East Central Iowa Acute Care, PLLC
• Eastern Iowa Anesthesia PC
• Eastern Iowa Endodontics, PC (Eastern Iowa Endodontics)
• Eastern Iowa Health Center (Eastern Iowa Health Center Pharmacy)
• Eastern Iowa Health Center (Eastern Iowa Walk-In Clinic)
• Eastern Iowa Health Center (Eastern Iowa Dental Center)
• Eastern Iowa Health Center
• Eastern Iowa Health Center

• Optometrist in Cedar Rapids, IA
• Providers in Cedar Rapids, IA by specialty
• Optometrist in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.