State Line Eye Care Center, PC

Primary specialty

Eyewear SupplierTaxonomy code 332H00000X

Legal business name

STATE LINE EYE CARE CENTER, PC

Doing business as

State Line Eye Care Center Optical

Practice address

7701 State Line Rd
Kansas City, MO 64114-1635

Phone

(816) 444-2900

Fax

(816) 444-3341

NPI assigned

Mar 9, 2007

Last updated

Aug 1, 2008By the provider in NPPES

Organization subpart

Yes

Parent organization

STATE LINE EYE CARE CENTER, PCAs reported in NPPES

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

Authorized official

Name

Mr. Roland Sabates, M.D.

Title

President

Phone

(816) 444-2900

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• State Line Eye Care Center Optical Doing business as

Tax ID family

Johnson County Eye Care2 organizations share this tax ID, including this one

Part of

Johnson County Eye Care

Other organizations with this tax ID 1

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

• State Line Eye Care Center, PC

  dba Cass County Eye Care Center Optical

  • Eyewear Supplier
  • Belton, MO
  • NPI 1770615601
  NPD tax ID

Locations

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

{
    "created_epoch": "1173398400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1217548800000",
    "number": "1174655955",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7701 STATE LINE RD",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641141635",
            "telephone_number": "816-444-2900",
            "fax_number": "816-444-3341"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7701 STATE LINE RD",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641141635",
            "telephone_number": "816-444-2900",
            "fax_number": "816-444-3341"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STATE LINE EYE CARE CENTER, PC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "STATE LINE EYE CARE CENTER, PC",
        "enumeration_date": "2007-03-09",
        "last_updated": "2008-08-01",
        "status": "A",
        "authorized_official_last_name": "SABATES",
        "authorized_official_first_name": "ROLAND",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "816-444-2900",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "19517031",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "323585208",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "State Line Eye Care Center Optical",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Debra Pomroy Starr
• Kristin Starr
• Patrick Joseph Starr Sr.
• Nickolas Stasic, M.D.
• State Line Eye Care Center, PC (Brookside Eye Care Center)
• State Line Eye Care Center, PC
• State Line Medical Group LLC
• State Line Psychiatric Consultants LLC
• State of Missouri (Kansas City Regional Center)
• State of Missouri (Center for Behavioral Health)

• Eyewear Supplier in Kansas City, MO
• Providers in Kansas City, MO by specialty
• Eyewear Supplier in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2008; 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.