Jeffrey Ryan Wiedrich, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

2664 Issued in CO

Practice address

1100 Main St
Fort Morgan, CO 80701-2036

Phone

(806) 336-7105

NPI assigned

Sep 11, 2008

Last updated

Nov 30, 2017By 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

Medicare fee-for-service enrollment

Enrolled in CO

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

Specialty

Optometry

Education

Southern College of Optometry, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

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.

• Fort Morgan Eye Care LLC

  • Clinic/Center
  • Fort Morgan, CO
  • NPI 1093229718
  Medicare reassignment NPD Authorized official
• Martin Road Eye Care Inc

  • Optometrist
  • Amarillo, TX
  • NPI 1144496381
  NPD
• Samuel Jeng, M.D., P.C.

  • Ophthalmology Physician
  • Greeley, CO
  • NPI 1821356163
  NPD (past)

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

{
    "created_epoch": "1221091200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1512000000000",
    "number": "1225287444",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 MAIN ST",
            "city": "FORT MORGAN",
            "state": "CO",
            "postal_code": "807012036",
            "telephone_number": "806-336-7105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 MAIN ST",
            "city": "FORT MORGAN",
            "state": "CO",
            "postal_code": "807012036",
            "telephone_number": "806-336-7105"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIEDRICH",
        "first_name": "JEFFREY",
        "middle_name": "RYAN",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-09-11",
        "last_updated": "2017-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CO",
            "license": "2664",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Eric Wenzler, PHARMD
• Aimee Whatley, NP
• Ryan V Wheatley, CRNA
• Jeff Wheeler
• Sarah Whitney, NP
• Brenda Wildrick, BA
• Robert Leroy Wilhelm, DDS
• Amanda Wilkin
• Stephen C. Wills, M.D.
• Jenifer L Wilson, PHARMD

• Optometrist in Fort Morgan, CO
• Providers in Fort Morgan, CO by specialty
• Optometrist in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2017; 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.