Organization Active NPI

Family Eye Health Center LLC

  • Optometrist
  • Des Moines, IA
National Provider Identifier
1164067989
Registry record updated Nov 15, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
FAMILY EYE HEALTH CENTER LLC
Practice address
6004 SW 9TH St
Des Moines, IA 50315-5011
Phone
(515) 287-0820
NPI assigned
Nov 15, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 15, 2019

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

Authorized official

Name
Rebecca Jean Gleason
Title
Business Manager
Phone
(515) 287-0820

Specialties & licenses 1

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

Addresses

Primary practice location

6004 SW 9TH St
Des Moines, IA 50315-5011

Mailing address

6004 SW 9TH St
Des Moines, IA 50315-5011
Phone (515) 287-0820

Other identifiers 1

IdentifierTypeStateIssuer
1805020MedicaidIA

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1573776000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1573776000000",
    "number": "1164067989",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6004 SW 9TH ST",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503155011",
            "telephone_number": "515-287-0820"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6004 SW 9TH ST",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503155011",
            "telephone_number": "515-287-0820"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY EYE HEALTH CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-11-15",
        "last_updated": "2019-11-15",
        "status": "A",
        "authorized_official_last_name": "GLEASON",
        "authorized_official_first_name": "REBECCA",
        "authorized_official_middle_name": "JEAN",
        "authorized_official_title_or_position": "BUSINESS MANAGER",
        "authorized_official_telephone_number": "515-287-0820"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1805020",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Des Moines, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2019; 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.