Individual provider Active NPI

Amy Lee Ritzheimer, O.D.

  • Optometrist
  • Centralia, IL
National Provider Identifier
1295167732
Registry record updated Aug 7, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
046.010720 Issued in IL
Practice address
899 E McCord St
Centralia, IL 62801-3003
Phone
(618) 969-8777
Fax
(618) 997-6250
NPI assigned
Aug 7, 2013
Last updated
Aug 7, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 7, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 046.010720 IL Primary

Addresses

Primary practice location

899 E McCord St
Centralia, IL 62801-3003

Mailing address

1200 W Deyoung St
P.O. Box 1178
Marion, IL 62959-4437
Phone (618) 969-8777

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20131010001434 IL Practitioner - Optometry 5890929616 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University of Missouri St Louis - School of Optometry, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Marion Eye Centers LTDGroup PAC ID 3072426774, 38 clinicians

Practice addresses (Care Compare)

899 E McCord St
Centralia, IL 62801-3003
Phone (618) 532-1997

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
046.010720ILMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Marion Eye Centers LTD. Optometrist CurrentSince Aug 1, 2013 Accepting new patients
Marion Eye Centers LTD. Optometrist CurrentSince Aug 1, 2013 Accepting new patients

Locations

1950 Franklin St
Carlyle, IL 62231
Phone (618) 384-5112

899 E McCord St
Centralia, IL 62801
Phone (618) 532-1997

1200 W Deyoung St
Marion, IL 62959
Phone 61899356861290

2900 Broadway St
#A
Mount Vernon, IL 62864
Phone (618) 244-2777

1180 W Saint Louis St
Nashville, IL 62263
Phone (618) 327-3900

1103 W Main St
Salem, IL 62881
Phone (618) 548-0100

300 W Randolph St
Vandalia, IL 62471
Phone (618) 283-7100

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1375833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1375833600000",
    "number": "1295167732",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 W DEYOUNG ST",
            "address_2": "P.O. BOX 1178",
            "city": "MARION",
            "state": "IL",
            "postal_code": "629594437",
            "telephone_number": "618-969-8777",
            "fax_number": "618-997-6250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "899 E MCCORD ST",
            "city": "CENTRALIA",
            "state": "IL",
            "postal_code": "628013003",
            "telephone_number": "618-969-8777",
            "fax_number": "618-997-6250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RITZHEIMER",
        "first_name": "AMY",
        "middle_name": "LEE",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-08-07",
        "last_updated": "2013-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046.010720",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Centralia, IL

Sources for this page

Verify at the official NPI Registry.