Ea Sanders, OD LLC

Primary specialty

OptometristTaxonomy code 152W00000X

Legal business name

EA SANDERS, OD LLC

Practice address

2509 Bufflehead Ave
Wausau, WI 54401-9191

Phone

(715) 573-7222

NPI assigned

Oct 6, 2014

Last updated

Oct 6, 2014By 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

Elizabeth A Bergo, O.D.

Title

Optometrist

Phone

(715) 573-7222

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1412553600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1412553600000",
    "number": "1326441387",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2509 BUFFLEHEAD AVE",
            "city": "WAUSAU",
            "state": "WI",
            "postal_code": "544019191",
            "telephone_number": "715-573-7222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2509 BUFFLEHEAD AVE",
            "city": "WAUSAU",
            "state": "WI",
            "postal_code": "544019191",
            "telephone_number": "715-573-7222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EA SANDERS, OD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-10-06",
        "last_updated": "2014-10-06",
        "status": "A",
        "authorized_official_last_name": "BERGO",
        "authorized_official_first_name": "ELIZABETH",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OPTOMETRIST",
        "authorized_official_telephone_number": "715-573-7222",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Optometrist in Wausau, WI
• Providers in Wausau, WI by specialty
• Optometrist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2014; 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.