Polk City Eyecare Inc

Primary specialty

OptometristTaxonomy code 152W00000X

License

02115 Issued in IA

Legal business name

POLK CITY EYECARE INC

Practice address

905 West Bridge Road
Suite 1
Polk City, IA 50226-2254

Phone

(515) 329-6454

Fax

(515) 984-3436

NPI assigned

Apr 10, 2017

Organization subpart

No

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

Authorized official

Name

Dr. Traci Ann Friedman, ODNPI 1851364921

Title

OD /Owner

Phone

(515) 329-6454

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IA

Enrollment records 1

Locations

Practitioners 2

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

• Traci Ann Friedman, OD

  • Optometrist
  • Polk City, IA
  • NPI 1851364921

  IA, Optometrist

  Medicare reassignment NPD Authorized official
• McKenzie Friedman

  • Optometrist
  • Urbandale, IA
  • NPI 1124828546
  NPD (past)

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

{
    "created_epoch": "1491782400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1519776000000",
    "number": "1215460910",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "905 WEST BRIDGE ROAD",
            "address_2": "SUITE 1",
            "city": "POLK CITY",
            "state": "IA",
            "postal_code": "502262254",
            "telephone_number": "515-329-6454",
            "fax_number": "515-984-3436"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "905 WEST BRIDGE ROAD",
            "address_2": "SUITE 1",
            "city": "POLK CITY",
            "state": "IA",
            "postal_code": "502262254",
            "telephone_number": "515-329-6454",
            "fax_number": "515-984-3436"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "POLK CITY EYECARE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-04-10",
        "last_updated": "2018-02-28",
        "status": "A",
        "authorized_official_last_name": "FRIEDMAN",
        "authorized_official_first_name": "TRACI",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "OD /OWNER",
        "authorized_official_telephone_number": "515-329-6454",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "IA",
            "license": "02115",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Optometrist in Polk City, IA
• Providers in Polk City, IA by specialty
• Optometrist in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2018; 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.