Rejuvenate Light and Vision Center

Primary specialty

OptometristTaxonomy code 152W00000X

Legal business name

REJUVENATE LIGHT AND VISION CENTER

Practice address

220 N Massey Blvd
Nixa, MO 65714-8324

Phone

(417) 374-1088

NPI assigned

Feb 23, 2026

Last updated

Mar 24, 2026By 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

Cade John Kowallis, ODNPI 1952781262

Title

Owner

Phone

(417) 604-0188

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Enrolled in MO

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Cade John Kowallis, O.D.

  • Optometrist
  • Nixa, MO
  • NPI 1952781262
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1771804800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1774310400000",
    "number": "1366396889",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "220 N MASSEY BLVD",
            "city": "NIXA",
            "state": "MO",
            "postal_code": "657148324",
            "telephone_number": "417-374-1088"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "220 N MASSEY BLVD",
            "city": "NIXA",
            "state": "MO",
            "postal_code": "657148324",
            "telephone_number": "417-374-1088"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REJUVENATE LIGHT AND VISION CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-02-23",
        "last_updated": "2026-03-24",
        "certification_date": "2026-03-24",
        "status": "A",
        "authorized_official_last_name": "KOWALLIS",
        "authorized_official_first_name": "CADE",
        "authorized_official_middle_name": "JOHN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "417-604-0188",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "152WC0802X",
            "taxonomy_group": "",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "152WP0200X",
            "taxonomy_group": "",
            "desc": "Optometrist, Pediatrics",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "152WV0400X",
            "taxonomy_group": "",
            "desc": "Optometrist, Vision Therapy",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brittany Ramsey, COTA/L
• Shelby Reams
• Courtney Reel
• Regional Care of Nixa, LLC (Christian Health and Rehabilitation of Nixa)
• Regional Services (Coxhealth School Based Telemedicine)
• Reliance Home Health Products, Inc.
• Renal Care Group of the Midwest, Inc. (Renal Care Group Nixa)
• Kathleen G Rice, MD
• Cynthia M Richards, LICSW
• Elena Chong Rieth, O.T.

• Optometrist in Nixa, MO
• Providers in Nixa, MO by specialty
• Optometrist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2026; 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.