Organization Active NPI

Dubuque Optometric, P.C.

  • Optometrist
  • Dubuque, IA
National Provider Identifier
1376661777
Registry record updated May 2, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
DUBUQUE OPTOMETRIC, P.C.
Practice address
3343 Center Grove Dr
Dubuque, IA 52003-5264
Phone
(563) 588-2093
Fax
(563) 588-0590
NPI assigned
Mar 26, 2007
Last updated
May 2, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 2, 2013

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

Authorized official

Name
Lynn M Lester-Howland
Title
Owner/Operator
Phone
(563) 588-2093

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X NU Primary

Addresses

Primary practice location

3343 Center Grove Dr
Dubuque, IA 52003-5264

Mailing address

3343 Center Grove Dr
Dubuque, IA 52003-5264
Phone (563) 588-2093

Other identifiers 2

IdentifierTypeStateIssuer
0084616MedicaidIA
07574OtherIAWELLMARK BLUE CROSS BLUE

National Provider Directory

National Provider Directory

Locations

3343 Center Grove Dr
Dubuque, IA 52003
Phone (319) 557-3040

Practitioners & affiliated clinicians

Practitioners 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1174867200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1367452800000",
    "number": "1376661777",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3343 CENTER GROVE DR",
            "city": "DUBUQUE",
            "state": "IA",
            "postal_code": "520035264",
            "telephone_number": "563-588-2093",
            "fax_number": "563-588-0590"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3343 CENTER GROVE DR",
            "city": "DUBUQUE",
            "state": "IA",
            "postal_code": "520035264",
            "telephone_number": "563-588-2093",
            "fax_number": "563-588-0590"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DUBUQUE OPTOMETRIC, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-26",
        "last_updated": "2013-05-02",
        "status": "A",
        "authorized_official_last_name": "LESTER-HOWLAND",
        "authorized_official_first_name": "LYNN",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER/OPERATOR",
        "authorized_official_telephone_number": "563-588-2093"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0084616",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLMARK BLUE CROSS BLUE",
            "identifier": "07574",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dubuque, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 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.