Individual provider Active NPI

Ramona D Mitchell, O.D.

  • Optometrist
  • Grinnell, IA
National Provider Identifier
1174505143
Registry record updated Feb 8, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
02012 Issued in IA
Practice address
208 West St
Grinnell, IA 50112-2014
Phone
(641) 236-4002
Fax
(641) 236-8687
NPI assigned
Nov 16, 2005
Last updated
Feb 8, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 8, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 02012 IA Primary

Addresses

Primary practice location

208 West St
Grinnell, IA 50112-2014

Mailing address

PO Box 420
Grinnell, IA 50112-0420
Phone (641) 236-4002

Other identifiers 4

IdentifierTypeStateIssuer
232577OtherIAMIDLANDS CHOICE
1102269MedicaidIA
73375OtherIACOVENTRY
51707OtherIAWELLMARK BC/BS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050324000297 IA Practitioner - Optometry 2860448800 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Indiana University - School of Optometry, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Eye Care Associates of Co LLCGroup PAC ID 9537597828, 63 clinicians

Practice addresses (Care Compare)

200 Army Post Rd
Suite 16
Des Moines, IA 50315-6203
Phone (515) 287-5565

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery78

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
02012IAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Eye Care Associates of Co LLC Optometrist CurrentSince Jan 29, 2024 Accepting new patients
Eye Care Associates of Co LLC Optometrist CurrentSince Jan 29, 2024 Accepting new patients

Locations

200 Army Post Rd
Ste 16
Des Moines, IA 50315
Phone (515) 287-5565

1534 28th Ave N
#515
Fort Dodge, IA 50501
Phone (515) 573-1145

208 West St
Grinnell, IA 50112
Phone (641) 236-4002

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1132099200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1454889600000",
    "number": "1174505143",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 420",
            "city": "GRINNELL",
            "state": "IA",
            "postal_code": "501120420",
            "telephone_number": "641-236-4002",
            "fax_number": "641-236-8687"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "208 WEST ST",
            "city": "GRINNELL",
            "state": "IA",
            "postal_code": "501122014",
            "telephone_number": "641-236-4002",
            "fax_number": "641-236-8687"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MITCHELL",
        "first_name": "RAMONA",
        "middle_name": "D",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-16",
        "last_updated": "2016-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IA",
            "license": "02012",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MIDLANDS CHOICE",
            "identifier": "232577",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1102269",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COVENTRY",
            "identifier": "73375",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLMARK BC/BS",
            "identifier": "51707",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Grinnell, IA

Sources for this page

Verify at the official NPI Registry.