The Christian Eye Clinic, PLC

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

33949 Issued in IA

Legal business name

THE CHRISTIAN EYE CLINIC, PLC

Practice address

7011 Douglas Ave
Des Moines, IA 50322-3223

Phone

(515) 333-3333

Fax

(515) 362-7933

NPI assigned

Apr 5, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Emad Ragheb Shenouda, MDNPI 1336109545

Title

President

Phone

(515) 333-3333

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in IA

Enrollment records 1

Tax ID family

The Christian PLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• The Christian Eye Clinic PLC

  • Ophthalmology Physician
  • Urbandale, IA
  • NPI 1689910218
  NPD tax ID

Locations

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

• The Christian Eye Clinic PLC

  • Ophthalmology Physician
  • Urbandale, IA
  • NPI 1689910218
  NPPES parent name

Practitioners 1

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

• Emad R Shenouda, MD

  • Ophthalmology Physician
  • Des Moines, IA
  • NPI 1336109545
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1207353600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1414972800000",
    "number": "1194998658",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7703",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503237703",
            "telephone_number": "515-333-3333",
            "fax_number": "515-283-2020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7011 DOUGLAS AVE",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503223223",
            "telephone_number": "515-333-3333",
            "fax_number": "515-362-7933"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE CHRISTIAN EYE CLINIC, PLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-05",
        "last_updated": "2014-11-03",
        "status": "A",
        "authorized_official_last_name": "SHENOUDA",
        "authorized_official_first_name": "EMAD",
        "authorized_official_middle_name": "RAGHEB",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "515-333-3333",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": "IA",
            "license": "33949",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1229203",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Ophthalmology Physician in Des Moines, IA
• Providers in Des Moines, IA by specialty
• Ophthalmology Physician in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2014; 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.