Grene Vision Group LLC
Organization Active NPI Optometrist · Winfield, KS
NPI 1295940633 · NPPES record last updated Feb 20, 2008
Key facts
- NPI
- 1295940633
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Optometrist 152W00000X
- Legal business name
- GRENE VISION GROUP LLC
- Practice address
- 117 E Ninth
Winfield, KS 67156 - Phone
- (620) 221-0740
- Fax
- (620) 221-0738
- NPI assigned
- May 11, 2007
- Organization subpart
- No
Authorized official
- Name
- Sheryl Davenport
- Title
- Insurance Department Supervisor
- Phone
- (316) 858-3830
Other NPIs on the same Medicare enrollment 26
Practitioners 2
-
Betty J Cantrell, OD
-
Gail L Burden, OD
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in KS
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040407000095 | KS | Part B Supplier - Clinic/Group Practice | 1254324023 |
Receives reassigned benefits from 45 practitioners 26 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Wellington, KS; Wichita, KS; Winfield, KS; Yates Center, KS; El Dorado, KS; Neodesha, KS; Lyons, KS; Hutchinson, KS… |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist |
152W00000X | Yes | ||
| Ophthalmology Physician |
207W00000X |
Addresses
Primary practice location
117 E Ninth
Winfield, KS 67156
Mailing address
1851 N Webb Rd
Attn FLR2
Wichita, KS 67206-3413
Phone (316) 636-2010
Other providers in Winfield, KS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 20, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.