Active NPI
Carol L Peters, OD
- Optometrist
- Greeley, CO
National Provider Identifier
1174509996
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- OPT-1223
- Practice address
- 2867 35TH Ave
Suite a
Greeley, CO 80634-9407 - Phone
- (970) 346-1411
- NPI assigned
- Dec 22, 2005
- Last updated
- Nov 16, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | OPT-1223 | CO | Primary |
Addresses
Primary practice location
2867 35TH Ave
Suite a
Greeley, CO 80634-9407
Mailing address
102 Eagle Dr
Milliken, CO 80543-9623
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- HHS exclusion list flag
- CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found.
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1223 | CO | MD | Clinical Social Worker |
| OPT-1223 | CO | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Bowen Eye Care Clinic. LLC | Optometrist | Past | Accepting new patients |
Organizations & group practices 1
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": "1135209600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1195171200000",
"number": "1174509996",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "102 EAGLE DR",
"city": "MILLIKEN",
"state": "CO",
"postal_code": "805439623"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2867 35TH AVE",
"address_2": "SUITE A",
"city": "GREELEY",
"state": "CO",
"postal_code": "806349407",
"telephone_number": "970-346-1411"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PETERS",
"first_name": "CAROL",
"middle_name": "L",
"name_prefix": "Dr.",
"credential": "OD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-12-22",
"last_updated": "2007-11-16",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "CO",
"license": "OPT-1223",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Greeley, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.