NPIMap

Organization Active NPI

My Eye Doctor, LLC

  • Optometrist
  • Moberly, MO
National Provider Identifier
1275730038
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1999137663 Issued in MO
Legal business name
MY EYE DOCTOR, LLC
Practice address
1301 E Highway 24
Inside Wal-Mart Vision Center
Moberly, MO 65270-3683
Phone
(660) 263-5885
Fax
(660) 263-2362
NPI assigned
Jun 27, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Kevin Dean Gunnerson, O.D.NPI 1104839661
Title
Owner
Phone
(660) 263-5885

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 1999137663 MO Primary

Addresses

Primary practice location

1301 E Highway 24
Inside Wal-Mart Vision Center
Moberly, MO 65270-3683

Mailing address

1301 E Highway 24
Inside Wal-Mart Vision Center
Moberly, MO 65270-3683
Phone (660) 263-5885

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1182902400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1275730038",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1301 E HIGHWAY 24",
            "address_2": "INSIDE WAL-MART VISION CENTER",
            "city": "MOBERLY",
            "state": "MO",
            "postal_code": "652703683",
            "telephone_number": "660-263-5885",
            "fax_number": "660-263-2362"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 E HIGHWAY 24",
            "address_2": "INSIDE WAL-MART VISION CENTER",
            "city": "MOBERLY",
            "state": "MO",
            "postal_code": "652703683",
            "telephone_number": "660-263-5885",
            "fax_number": "660-263-2362"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MY EYE DOCTOR, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-27",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "GUNNERSON",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_middle_name": "DEAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "660-263-5885",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "MO",
            "license": "1999137663",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Moberly, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.