NPIMap

Organization Active NPI

Associated Optometrists, PC

Doing business as Edgebrook Eye Care

  • Optometrist
  • Rockford, IL
National Provider Identifier
1396753513
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
ASSOCIATED OPTOMETRISTS, PC
Doing business as
Edgebrook Eye Care
Practice address
1641 N Alpine Rd
Suite 205
Rockford, IL 61107-1458
Phone
(815) 397-5337
Fax
(815) 397-5540
NPI assigned
Aug 3, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. David A Nielsen, O.D.NPI 1285659367
Title
Optometrist
Phone
(815) 397-5337

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 IL Primary

Addresses

Primary practice location

1641 N Alpine Rd
Suite 205
Rockford, IL 61107-1458

Mailing address

1641 N Alpine Rd
Suite 205
Rockford, IL 61107-1458
Phone (815) 397-5337

Other names 1

  • Edgebrook Eye Care Doing business as

National Provider Directory

National Provider Directory

Locations

1641 N Alpine Rd
Ste 205
Rockford, IL 61107
Phone (815) 397-5337

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": "1154563200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1396753513",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1641 N ALPINE RD",
            "address_2": "SUITE 205",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611071458",
            "telephone_number": "815-397-5337",
            "fax_number": "815-397-5540"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1641 N ALPINE RD",
            "address_2": "SUITE 205",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611071458",
            "telephone_number": "815-397-5337",
            "fax_number": "815-397-5540"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ASSOCIATED OPTOMETRISTS, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-03",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "NIELSEN",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OPTOMETRIST",
        "authorized_official_telephone_number": "815-397-5337",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Edgebrook Eye Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Rockford, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.