NPIMap

Organization Active NPI

Fairway Eye Center, Inc

  • Optometrist
  • Fairway, KS
National Provider Identifier
1194906461
Registry record updated Aug 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1672 Issued in KS
Legal business name
FAIRWAY EYE CENTER, INC
Practice address
3414 Shawnee Mission Pkwy
Fairway, KS 66205-2663
Phone
(913) 362-2323
Fax
(913) 362-2333
NPI assigned
Nov 15, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 9, 2023

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

Authorized official

Name
Dr. Mark Bunde, O.D.NPI 1184636441
Title
Owner/Optomertist
Phone
(913) 362-2323

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
OptometristGroup: 193200000X MULTI-SPECIALTY GROUP 152W00000X 1672 KS Primary

Addresses

Primary practice location

3414 Shawnee Mission Pkwy
Fairway, KS 66205-2663

Mailing address

3414 Shawnee Mission Pkwy
Fairway, KS 66205-2663
Phone (913) 362-2323

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO, KS2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040810000468 MO Part B Supplier - Clinic/Group Practice 9234101361 Receives reassigned benefits from 5 practitioners
Practice locations: Raytown, MO
O20050721001118 KS Part B Supplier - Clinic/Group Practice 9234101361 Receives reassigned benefits from 3 practitioners
Practice locations: Fairway, KS

National Provider Directory

National Provider Directory

Locations

11707 Roe Ave
Ste A
Leawood, KS 66211
Phone (913) 491-9123

1915 W Jesse James Rd
Exclsor Sprgs, MO 64024
Phone (816) 637-3541

4181 Broadway
Kansas City, MO 64111
Phone (816) 756-3577

1528 NE 96th St
Ste A
Liberty, MO 64068
Phone (816) 781-5444

10215 E State Route 350
Ste E
Raytown, MO 64138
Phone (816) 313-5060

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1195084800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1691539200000",
    "number": "1194906461",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3414 SHAWNEE MISSION PKWY",
            "city": "FAIRWAY",
            "state": "KS",
            "postal_code": "662052663",
            "telephone_number": "913-362-2323",
            "fax_number": "913-362-2333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3414 SHAWNEE MISSION PKWY",
            "city": "FAIRWAY",
            "state": "KS",
            "postal_code": "662052663",
            "telephone_number": "913-362-2323",
            "fax_number": "913-362-2333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAIRWAY EYE CENTER, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-15",
        "last_updated": "2023-08-09",
        "certification_date": "2023-08-09",
        "status": "A",
        "authorized_official_last_name": "BUNDE",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "OWNER/OPTOMERTIST",
        "authorized_official_telephone_number": "913-362-2323",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": "KS",
            "license": "1672",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairway, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2023; 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.