Organization Active NPI

Eye Care Professionals, LLC

  • Optometrist
  • North Platte, NE
National Provider Identifier
1265887160
Registry record updated Jun 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1416 Issued in NE
Legal business name
EYE CARE PROFESSIONALS, LLC
Practice address
810 W Reid Ave Ste 1
North Platte, NE 69101-6582
Phone
(308) 221-2020
Fax
(308) 221-6017
NPI assigned
Apr 28, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 28, 2023

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

Authorized official

Name
Dr. Mollie J Golden, O.D.NPI 1316359011
Title
OD/Owner
Phone
(308) 221-2020

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 1416 NE Primary
Eyewear Supplier 332H00000X

Addresses

Primary practice location

810 W Reid Ave Ste 1
North Platte, NE 69101-6582

Mailing address

810 W Reid Ave Ste 1
North Platte, NE 69101-6582
Phone (308) 221-2020

Other identifiers 1

IdentifierTypeStateIssuer
50723935701MedicaidNE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160818002497 NE Part B Supplier - Clinic/Group Practice 1456646223 Receives reassigned benefits from 1 practitioner
Practice locations: North Platte, NE

National Provider Directory

National Provider Directory

Locations

810 W Reid Ave
Ste 2
North Platte, NE 69101
Phone (308) 221-2020

810 W Reid Ave
Ste 1
North Platte, NE 69101
Phone (308) 221-2020

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1461801600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1687910400000",
    "number": "1265887160",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "810 W REID AVE STE 1",
            "city": "NORTH PLATTE",
            "state": "NE",
            "postal_code": "691016582",
            "telephone_number": "308-221-2020",
            "fax_number": "308-221-6017"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "810 W REID AVE STE 1",
            "city": "NORTH PLATTE",
            "state": "NE",
            "postal_code": "691016582",
            "telephone_number": "308-221-2020",
            "fax_number": "308-221-6017"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EYE CARE PROFESSIONALS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-04-28",
        "last_updated": "2023-06-28",
        "certification_date": "2023-06-28",
        "status": "A",
        "authorized_official_last_name": "GOLDEN",
        "authorized_official_first_name": "MOLLIE",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OD/OWNER",
        "authorized_official_telephone_number": "308-221-2020",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "NE",
            "license": "1416",
            "primary": true
        },
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "50723935701",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in North Platte, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.