Columbia Retina Clinic, LTD.

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

R5072 Issued in MO

Legal business name

COLUMBIA RETINA CLINIC, LTD.

Practice address

500 N Keene St
Suite 102
Columbia, MO 65201-8104

Phone

(573) 449-3846

Fax

(573) 499-1451

NPI assigned

Mar 12, 2007

Last updated

Sep 14, 2009By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Kathy Cundiff

Title

General Manager

Phone

(573) 449-3846

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

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

{
    "created_epoch": "1173657600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1252886400000",
    "number": "1235261645",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 N KEENE ST",
            "address_2": "SUITE 102",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652018104",
            "telephone_number": "573-449-3846",
            "fax_number": "573-499-1451"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 N KEENE ST",
            "address_2": "SUITE 102",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652018104",
            "telephone_number": "573-449-3846",
            "fax_number": "573-499-1451"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLUMBIA RETINA CLINIC, LTD.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-12",
        "last_updated": "2009-09-14",
        "status": "A",
        "authorized_official_last_name": "CUNDIFF",
        "authorized_official_first_name": "KATHY",
        "authorized_official_title_or_position": "GENERAL MANAGER",
        "authorized_official_telephone_number": "573-449-3846"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "MO",
            "license": "R5072",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "DH2433",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201299708",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Columbia Public Schools
• Columbia Radiology Imaging Services, LLC (Advanced Radiology of Columbia)
• Columbia Radiology, LTD
• Columbia Regional Hospital - Psychiatric Unit (Curators of the University of Missouri)
• Columbia Residential, LLC (Bluff Creek Terrace Assisted Living)
• Columbia Skilled Nursing Associates LLC
• Columbia Speech Therapy Services, LLC
• Columbia Sports Chiropractic, LLC
• Columbia Surgical Associates Inc
• Columbia Surgical Prosthodontics LLC (Vanderveen Dental Center)

• Ophthalmology Physician in Columbia, MO
• Providers in Columbia, MO by specialty
• Ophthalmology Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2009; 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.