Individual provider Active NPI

Cheryl Bronner, OD

  • Optometrist
  • Spencer, IA
National Provider Identifier
1194758581
Registry record updated Jan 25, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
02040 Issued in IA
Practice address
714 S Grand Ave
Spencer, IA 51301-5730
Phone
(712) 262-3982
NPI assigned
Jul 8, 2006
Last updated
Jan 25, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPT1692 CO
Optometrist 152W00000X 02040 IA Primary

Addresses

Primary practice location

714 S Grand Ave
Spencer, IA 51301-5730

Mailing address

1626 7TH Ave SE
Sioux Center, IA 51250-1197
Phone (720) 363-3192

Other identifiers 1

IdentifierTypeStateIssuer
638733OtherCOBCBS PROVIDER NUMBER

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
I20110902000260 IA Practitioner - Optometry 7911177746

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OPT1692COMDOptometrist
02040IAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Iowa Eye Institute, P.C. Past Accepting new patients
Allen S Jones OD PC Optometrist PastSince Jan 21, 2015 Accepting new patients
Hawkeye Exact, LLC Optometrist PastSince Nov 24, 2019 Accepting new patients
Iowa Eye Institute PC Past Accepting new patients

Organizations & group practices 5

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": "1152316800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1453680000000",
    "number": "1194758581",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1626 7TH AVE SE",
            "city": "SIOUX CENTER",
            "state": "IA",
            "postal_code": "512501197",
            "telephone_number": "720-363-3192"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "714 S GRAND AVE",
            "city": "SPENCER",
            "state": "IA",
            "postal_code": "513015730",
            "telephone_number": "712-262-3982"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRONNER",
        "first_name": "CHERYL",
        "name_prefix": "Mrs.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-08",
        "last_updated": "2016-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CO",
            "license": "OPT1692",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IA",
            "license": "02040",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PROVIDER NUMBER",
            "identifier": "638733",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Spencer, IA

Sources for this page

Verify at the official NPI Registry.