NPIMap

Organization Active NPI

David R Culver OD LTD

Doing business as Family Vision Care

  • Optometrist
  • Macomb, IL
National Provider Identifier
1386764942
Registry record updated Apr 29, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
46006825 Issued in IL
Legal business name
DAVID R CULVER OD LTD
Doing business as
Family Vision Care
Practice address
222 S Randolph St
Macomb, IL 61455-2210
Phone
(309) 833-4391
Fax
(309) 833-1691
NPI assigned
Mar 29, 2007
Last updated
Apr 29, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2008

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

Authorized official

Name
David R Culver, ODNPI 1720074396
Title
Owner
Phone
(309) 833-4391

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 46006825 IL Primary

Addresses

Primary practice location

222 S Randolph St
Macomb, IL 61455-2210

Mailing address

222 S Randolph St
Macomb, IL 61455-2210
Phone (309) 833-4391

Other identifiers 3

IdentifierTypeStateIssuer
5584003OtherILBCBS OF ILLINOIS
IL6825OtherILEYEMED
410021980OtherILRAILROAD MEDICARE

Other names 1

  • Family Vision Care Doing business as

National Provider Directory

National Provider Directory

Locations

222 S Randolph St
Macomb, IL 61455
Phone (309) 833-4391

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1175126400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1209427200000",
    "number": "1386764942",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "222 S RANDOLPH ST",
            "city": "MACOMB",
            "state": "IL",
            "postal_code": "614552210",
            "telephone_number": "309-833-4391",
            "fax_number": "309-833-1691"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "222 S RANDOLPH ST",
            "city": "MACOMB",
            "state": "IL",
            "postal_code": "614552210",
            "telephone_number": "309-833-4391",
            "fax_number": "309-833-1691"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAVID R CULVER OD LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-29",
        "last_updated": "2008-04-29",
        "status": "A",
        "authorized_official_last_name": "CULVER",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "309-833-4391",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": "46006825",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF ILLINOIS",
            "identifier": "5584003",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EYEMED",
            "identifier": "IL6825",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "410021980",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Family Vision Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Macomb, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2008; 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.