Spec Shoppe II

Primary specialty

OpticianTaxonomy code 156FX1800X

License

22104119 Issued in MO

Legal business name

SPEC SHOPPE II

Practice address

301 N Park St
Stanberry, MO 64489-1245

Phone

(660) 783-2870

NPI assigned

Jan 6, 2015

Last updated

Jan 6, 2015By 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

Jeffrey Mark Farnan

Title

Co-Owner

Phone

(660) 783-2870

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Polly A Nelson, O.D.

  • Optometrist
  • Savannah, MO
  • NPI 1295766657
  NPD (past)

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

{
    "created_epoch": "1420502400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1420502400000",
    "number": "1265820815",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 N PARK ST",
            "city": "STANBERRY",
            "state": "MO",
            "postal_code": "644891245"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 N PARK ST",
            "city": "STANBERRY",
            "state": "MO",
            "postal_code": "644891245",
            "telephone_number": "660-783-2870"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPEC SHOPPE II",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-01-06",
        "last_updated": "2015-01-06",
        "status": "A",
        "authorized_official_last_name": "FARNAN",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "MARK",
        "authorized_official_title_or_position": "CO-OWNER",
        "authorized_official_telephone_number": "660-783-2870"
    },
    "taxonomies": [
        {
            "code": "156FX1800X",
            "taxonomy_group": "",
            "desc": "Technician/Technologist, Optician",
            "state": "MO",
            "license": "22104119",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Northwest Health Services Inc (Stanberry R-II School District)
• Northwest Medical Center Association, Inc (Mosaic Family Care Stanberry)
• Northwest Missouri Supportive Services
• Pine View Manor, Inc.
• Pine View Manor, Inc.
• Stanberry Independent Living
• Stanberry R-II School
• Fallon L Stiens, D.D.S.
• TLC Care Center, Inc
• Kylee Townsend

• Optician in Stanberry, MO
• Providers in Stanberry, MO by specialty
• Optician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 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.