Lance Henderson

Primary specialty

OptometristTaxonomy code 152W00000X

License

ODP-1004 Issued in ID

Practice address

134 N State St
Preston, ID 83263-1143

Phone

(208) 852-3030

NPI assigned

Jan 8, 2007

Last updated

Apr 15, 2009By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in UT, ID2 enrollments

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 2

Specialty

Optometry

Education

Pacific University - College of Optometry, 1998

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Eye Care for You LLCGroup PAC ID 1951466481, shared by 2 NPIs, 3 clinicians

Aeg Utah Professional IncGroup PAC ID 2062918618, 6 clinicians

Eyecare Specialties of Idaho PCGroup PAC ID 2163927526, 5 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Eyecare Specialties of Idaho PC

  • Optometrist
  • Preston, ID
  • NPI 1417848037
  Medicare reassignment Care Compare group NPD
• Aeg Utah Professional Inc

  • Optometrist
  • Logan, UT
  • NPI 1154212777
  Medicare reassignment Care Compare group NPD
• Eye Care for You LLC

  • Optometrist
  • Preston, ID
  • NPI 1548405327
  Medicare reassignment
• Eye Care for You LLC

  • Optometrist
  • Logan, UT
  • NPI 1619112398
  Medicare reassignment
• Eye Care for You

  • Optometrist
  • Sandpoint, ID
  • NPI 1710042353
  NPD (past)
• Eye Care for You, P.C.

  • Optometrist
  • Preston, ID
  • NPI 1457418253
  NPD (past)
• Dr Roy R Gibson & Associates Optometrists P C

  • Optometrist
  • Roy, UT
  • NPI 1659557528
  NPD (past)

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

{
    "created_epoch": "1168214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1239753600000",
    "number": "1225186398",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "749 NORTH 4900 WEST",
            "address_2": "P.O. BOX 143",
            "city": "DAYTON",
            "state": "ID",
            "postal_code": "83232",
            "telephone_number": "208-747-3020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "134 N STATE ST",
            "city": "PRESTON",
            "state": "ID",
            "postal_code": "832631143",
            "telephone_number": "208-852-3030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENDERSON",
        "first_name": "LANCE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-08",
        "last_updated": "2009-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "ID",
            "license": "ODP-1004",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "807028800",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Muriel May Garvis, NP
• Jeannine Anne Groll, RDN
• Seth William Haslam, PHARMD.
• Health West, Inc. (Health West Preston Clinic)
• Healthy Care Solutions
• Aaron Henrie, RPHD
• Alan D Holt, CRNA
• Natalie J Hopper
• Karen Hull, LCSW
• Thomas Richard Hull, D.D.S.

• Optometrist in Preston, ID
• Providers in Preston, ID by specialty
• Optometrist in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.