NPIMap

Organization Active NPI

Mervi H Leyendeckers, O.D., P.C.

  • Optometrist
  • Quincy, IL
National Provider Identifier
1396046090
Registry record updated Dec 12, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
046008462 Issued in IL
Legal business name
MERVI H LEYENDECKERS, O.D., P.C.
Practice address
926 Broadway St
Quincy, IL 62301-2730
Phone
(217) 222-6888
Fax
(217) 222-6975
NPI assigned
Nov 11, 2010
Last updated
Dec 12, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 12, 2011

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

Authorized official

Name
Dr. Mervi H Leyendeckers, O.D.NPI 1083711642
Title
Optometrist
Phone
(217) 222-6888

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
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 046008462 IL Primary

Addresses

Primary practice location

926 Broadway St
Quincy, IL 62301-2730

Mailing address

926 Broadway Street
Quincy, IL 62301-2730
Phone (217) 222-6888

Other names 1

  • Broadway Vision Center Other name

National Provider Directory

National Provider Directory

Locations

926 Broadway St
Quincy, IL 62301
Phone (217) 222-6888

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": "1289433600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1323648000000",
    "number": "1396046090",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "926 BROADWAY STREET",
            "city": "QUINCY",
            "state": "IL",
            "postal_code": "623012730",
            "telephone_number": "217-222-6888",
            "fax_number": "217-222-6975"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "926 BROADWAY ST",
            "city": "QUINCY",
            "state": "IL",
            "postal_code": "623012730",
            "telephone_number": "217-222-6888",
            "fax_number": "217-222-6975"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MERVI H LEYENDECKERS, O.D., P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-11-11",
        "last_updated": "2011-12-12",
        "status": "A",
        "authorized_official_last_name": "LEYENDECKERS",
        "authorized_official_first_name": "MERVI",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "OPTOMETRIST",
        "authorized_official_telephone_number": "217-222-6888",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046008462",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Broadway Vision Center",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Quincy, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2011; 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.