Individual provider Active NPI

John G Thomsen, OD

  • Optometrist
  • Corning, IA
National Provider Identifier
1205801941
Registry record updated Oct 9, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1938T Issued in IA
Practice address
715 Davis Ave
Corning, IA 50841-1418
Phone
(641) 322-3147
Fax
(641) 322-3853
NPI assigned
Feb 17, 2006
Last updated
Oct 9, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 1938T IA Primary

Addresses

Primary practice location

715 Davis Ave
Corning, IA 50841-1418

Mailing address

715 Davis Ave
Corning, IA 50841-1418
Phone (641) 322-3147

Other identifiers 2

IdentifierTypeStateIssuer
2081133MedicaidIA
1081133MedicaidIA

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
I20100329000148 IA Practitioner - Optometry 8123153921 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University of Houston - College of Optometry, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Eye Care Associates of Co LLCGroup PAC ID 9537597828, 63 clinicians

Practice addresses (Care Compare)

807 N Sumner Ave
Creston, IA 50801-1350
Phone (641) 782-2111

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery47

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1938TIAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Dr. Robert H Sharp, PC Optometrist Current Accepting new patients
Eye Care Associates of Co LLC Optometrist CurrentSince Sep 16, 2023 Accepting new patients
Eye Care Associates of Co LLC Optometrist CurrentSince Sep 16, 2023 Accepting new patients
Dr. Robert H Sharp, PC Optometrist CurrentSince Dec 26, 1991 Accepting new patients
Dr. Robert H. Sharp, P.C. Optometrist Past Accepting new patients

Locations

4 W 5th St
Atlantic, IA 50022
Phone (712) 243-1965

715 Davis Ave
Corning, IA 50841
Phone (641) 322-3147

807 N Sumner Ave
Creston, IA 50801
Phone (515) 222-6400

1534 28th Ave N
#515
Fort Dodge, IA 50501
Phone (515) 573-1145

514 N 4th St
Red Oak, IA 51566
Phone (712) 623-9433

Organizations & group practices 6

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": "1140134400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1349740800000",
    "number": "1205801941",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "715 DAVIS AVE",
            "city": "CORNING",
            "state": "IA",
            "postal_code": "508411418",
            "telephone_number": "641-322-3147",
            "fax_number": "641-322-3853"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "715 DAVIS AVE",
            "city": "CORNING",
            "state": "IA",
            "postal_code": "508411418",
            "telephone_number": "641-322-3147",
            "fax_number": "641-322-3853"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMSEN",
        "first_name": "JOHN",
        "middle_name": "G",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-17",
        "last_updated": "2012-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IA",
            "license": "1938T",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2081133",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1081133",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Corning, IA

Sources for this page

Verify at the official NPI Registry.