NPIMap

Organization Active NPI

Prange Riley Optometrists, P.C.

  • Optometrist
  • Sullivan, MO
National Provider Identifier
1316072986
Registry record updated Aug 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
TO2592 Issued in MO
Legal business name
PRANGE RILEY OPTOMETRISTS, P.C.
Practice address
280 E Springfield Rd
Sullivan, MO 63080-1364
Phone
(573) 468-4032
Fax
(573) 468-2935
NPI assigned
Feb 22, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 14, 2025

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

Authorized official

Name
Jason T Riley, ODNPI 1477752053
Title
President-Owner
Phone
(573) 468-4032

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X TO2592 MO Primary

Addresses

Primary practice location

280 E Springfield Rd
Sullivan, MO 63080-1364

Mailing address

280 E Springfield Rd
Sullivan, MO 63080-1364
Phone (573) 468-4032

Other names 1

  • Sullivan Eye Care Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040528000313 MO Part B Supplier - Clinic/Group Practice 2264413814 Receives reassigned benefits from 4 practitioners
Practice locations: Sullivan, MO

National Provider Directory

National Provider Directory

Locations

280 E Springfield Rd
Sullivan, MO 63080
Phone (573) 468-4032

Practitioners & affiliated clinicians

Practitioners 8

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": "1172102400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1755129600000",
    "number": "1316072986",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "280 E SPRINGFIELD RD",
            "city": "SULLIVAN",
            "state": "MO",
            "postal_code": "630801364",
            "telephone_number": "573-468-4032",
            "fax_number": "573-468-2935"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "280 E SPRINGFIELD RD",
            "city": "SULLIVAN",
            "state": "MO",
            "postal_code": "630801364",
            "telephone_number": "573-468-4032",
            "fax_number": "573-468-2935"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRANGE RILEY OPTOMETRISTS, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-22",
        "last_updated": "2025-08-14",
        "certification_date": "2025-08-14",
        "status": "A",
        "authorized_official_last_name": "RILEY",
        "authorized_official_first_name": "JASON",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "PRESIDENT-OWNER",
        "authorized_official_telephone_number": "573-468-4032",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "MO",
            "license": "TO2592",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sullivan Eye Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Sullivan, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2025; 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.