Great River Eye Care, Inc.

Primary specialty

OptometristTaxonomy code 152W00000X

License

1761 Issued in IA

Legal business name

GREAT RIVER EYE CARE, INC.

Practice address

3337 Agency St
Burlington, IA 52601-1959

Phone

(319) 754-5022

Fax

(319) 754-0411

NPI assigned

May 3, 2013

Last updated

Jun 7, 2013By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Brad Weyers, O.D.

Title

Optometrist

Phone

(319) 754-5022

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1367539200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1370563200000",
    "number": "1316382302",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3337 AGENCY ST",
            "city": "BURLINGTON",
            "state": "IA",
            "postal_code": "526011959",
            "telephone_number": "319-754-5022",
            "fax_number": "319-754-0411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3337 AGENCY ST",
            "city": "BURLINGTON",
            "state": "IA",
            "postal_code": "526011959",
            "telephone_number": "319-754-5022",
            "fax_number": "319-754-0411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREAT RIVER EYE CARE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-05-03",
        "last_updated": "2013-06-07",
        "status": "A",
        "authorized_official_last_name": "WEYERS",
        "authorized_official_first_name": "BRAD",
        "authorized_official_title_or_position": "OPTOMETRIST",
        "authorized_official_telephone_number": "319-754-5022",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IA",
            "license": "1761",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0008839",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Matthew Granquist, PT, DPT
• Jolene LM Gray
• Great River Aea 16
• Great River Aea 16
• Great River Child Care Inc.
• Brandie Grinstead, LISW
• Grinstead, Pierce & Associates, LLC (O'Rourke, Grinstead, Pierce & Associates)
• Amy Rebecca Groeltz, DDS
• Jennifer Hamilton, RN
• Evan J Hammer, RPH

• Optometrist in Burlington, IA
• Providers in Burlington, IA by specialty
• Optometrist in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2013; 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.