State Line Eye Care Center, PC

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

Legal business name

STATE LINE EYE CARE CENTER, PC

Practice address

7701 State Line Rd
Kansas City, MO 64114-1635

Phone

(816) 444-2900

Fax

(816) 444-3304

NPI assigned

Jun 9, 2006

Organization subpart

No

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

Authorized official

Name

Lilliam (Lily) S Yohn

Title

Secretary/Office Manager

Phone

(816) 444-2900

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

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

{
    "created_epoch": "1149811200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1425340800000",
    "number": "1215978622",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7701 STATE LINE RD",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641141635",
            "telephone_number": "816-444-2900",
            "fax_number": "816-444-3304"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7701 STATE LINE RD",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641141635",
            "telephone_number": "816-444-2900",
            "fax_number": "816-444-3304"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STATE LINE EYE CARE CENTER, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-09",
        "last_updated": "2015-03-03",
        "status": "A",
        "authorized_official_last_name": "YOHN",
        "authorized_official_first_name": "LILLIAM (LILY)",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "SECRETARY/OFFICE MANAGER",
        "authorized_official_telephone_number": "816-444-2900"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "19517011",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "509417606",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kristin Starr
• Patrick Joseph Starr Sr.
• Nickolas Stasic, M.D.
• State Line Eye Care Center, PC
• State Line Eye Care Center, PC
• State Line Medical Group LLC
• State Line Psychiatric Consultants LLC
• State of Missouri
• State of Missouri
• State of Missouri

• All providers in Kansas City, MO
• Ophthalmology Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.