NPIMap

Organization Active NPI

Vision Care Clinic, P.C.

  • Optometrist
  • Council Bluffs, IA
National Provider Identifier
1144657354
Registry record updated Oct 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
VISION CARE CLINIC, P.C.
Practice address
200 S 29TH St
Council Bluffs, IA 51501-3449
Phone
(712) 325-4999
NPI assigned
Oct 2, 2013
Last updated
Oct 18, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 18, 2023

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

Authorized official

Name
Dr. Scott Alan Bowker, O.D.NPI 1891742383
Title
Co-President
Phone
(712) 263-2020

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X Primary

Addresses

Primary practice location

200 S 29TH St
Council Bluffs, IA 51501-3449

Mailing address

200 S 29TH St
Council Bluffs, IA 51501-3449
Phone (712) 325-4999

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040204000966 IA Part B Supplier - Clinic/Group Practice 8325931223 Receives reassigned benefits from 9 practitioners
7 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Sioux City, IA; Denison, IA; Onawa, IA; Moville, IA; Missouri Valley, IA; Manning, IA; Mapleton, IA; Council Bluffs, IA

Other NPIs on the same Medicare enrollment 7

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

National Provider Directory

National Provider Directory
Tax ID family
Vision Care Clinic PC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Locations

130 W Broadway
Council Bluffs, IA 51503
Phone (712) 325-4999

Practitioners & affiliated clinicians

Practitioners 2

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": "1380672000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1697587200000",
    "number": "1144657354",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 S 29TH ST",
            "city": "COUNCIL BLUFFS",
            "state": "IA",
            "postal_code": "515013449",
            "telephone_number": "712-325-4999",
            "fax_number": "712-256-4073"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 S 29TH ST",
            "city": "COUNCIL BLUFFS",
            "state": "IA",
            "postal_code": "515013449",
            "telephone_number": "712-325-4999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VISION CARE CLINIC, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-10-02",
        "last_updated": "2023-10-18",
        "certification_date": "2023-10-18",
        "status": "A",
        "authorized_official_last_name": "BOWKER",
        "authorized_official_first_name": "SCOTT",
        "authorized_official_middle_name": "ALAN",
        "authorized_official_title_or_position": "CO-PRESIDENT",
        "authorized_official_telephone_number": "712-263-2020",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Council Bluffs, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2023; 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.