NPIMap

Organization Active NPI

Creston M. Myers, OD, PC

Doing business as Family Vision Clinic of Alliance

  • Optometrist
  • Alliance, NE
National Provider Identifier
1164794863
Registry record updated Jan 28, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1202 Issued in NE
Legal business name
CRESTON M. MYERS, OD, PC
Doing business as
Family Vision Clinic of Alliance
Practice address
1317 W 3Rd St
Alliance, NE 69301-3125
Phone
(308) 762-4056
Fax
(308) 762-4063
NPI assigned
Jan 27, 2012
Last updated
Jan 28, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 28, 2012

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

Authorized official

Name
Dr. Creston M Myers, ODNPI 1578509873
Title
President
Phone
(308) 760-1038

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 1202 NE Primary

Addresses

Primary practice location

1317 W 3Rd St
Alliance, NE 69301-3125

Mailing address

PO Box 830
Alliance, NE 69301-0830
Phone (308) 762-4056

Other names 1

  • Family Vision Clinic of Alliance Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120313000135 NE Part B Supplier - Clinic/Group Practice 8123923018 Receives reassigned benefits from 1 practitioner
Practice locations: Alliance, NE

National Provider Directory

National Provider Directory

Locations

321 Box Butte Ave
Alliance, NE 69301
Phone (308) 762-4056

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": "1327622400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1327708800000",
    "number": "1164794863",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 830",
            "city": "ALLIANCE",
            "state": "NE",
            "postal_code": "693010830",
            "telephone_number": "308-762-4056",
            "fax_number": "308-762-4063"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1317 W 3RD ST",
            "city": "ALLIANCE",
            "state": "NE",
            "postal_code": "693013125",
            "telephone_number": "308-762-4056",
            "fax_number": "308-762-4063"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CRESTON M. MYERS, OD, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-01-27",
        "last_updated": "2012-01-28",
        "status": "A",
        "authorized_official_last_name": "MYERS",
        "authorized_official_first_name": "CRESTON",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "308-760-1038",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NE",
            "license": "1202",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Family Vision Clinic of Alliance",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Alliance, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2012; 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.